{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:39:47Z","timestamp":1776731987133,"version":"3.51.2"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:00:00Z","timestamp":1738108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100009122","name":"Ministry of Education","doi-asserted-by":"publisher","award":["2021R1I1A1A01048695"],"award-info":[{"award-number":["2021R1I1A1A01048695"]}],"id":[{"id":"10.13039\/100009122","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>This study aimed to evaluate the prognostic impact of permanent pacemaker (PPM) implantation within the first year after mitral valve (MV) surgery combined with the Cox-maze procedure, focusing on long-term outcomes, including overall mortality, infective endocarditis (IE) and ischaemic stroke.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We conducted a retrospective cohort study using data from the National Health Insurance Service (NHIS) in South Korea, identifying 10\u00a0127 patients who underwent MV surgery with the Cox-maze procedure between 2005 and 2020. Patients were classified into the PPM and non-PPM groups based on PPM implantation within 1 year postoperatively. The primary outcome was overall mortality, and secondary outcomes included risk factors for overall mortality, IE and ischaemic stroke. Multivariable Cox proportional hazards regression and Fine-Gray competing risk models were utilized for statistical analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Of the total cohort, 178 patients (1.76%) underwent PPM implantation. The overall mortality during the follow-up period was 20.5%, with no significant difference between the PPM and non-PPM groups. PPM implantation was not a significant risk factor for overall mortality (hazard ratio [HR], 0.825; 95% confidence interval [CI] 0.598\u20131.140; P\u2009=\u20090.244) or ischaemic stroke. However, PPM implantation was associated with a significantly increased risk of IE (HR, 2.015; 95% CI 1.179\u20133.442; P\u2009=\u20090.010).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>PPM implantation within the first year after MV surgery with the Cox-maze procedure does not significantly impact long-term mortality or ischaemic stroke risk but is associated with an increased risk of IE. The Cox-maze procedure remains advisable for patients with atrial fibrillation undergoing MV surgery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaf018","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T17:13:50Z","timestamp":1738170830000},"source":"Crossref","is-referenced-by-count":3,"title":["Prognostic impact of 1-year permanent pacemaker implantation after mitral valve surgery with the Cox-maze procedure"],"prefix":"10.1093","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8237-2542","authenticated-orcid":false,"given":"Jun Ho","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine , Seoul,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine, Hanyang University , Seoul,","place":["Korea"]},{"name":"Biostatistics Lab, Medical Research Collaborating Center, Hanyang University , Seoul,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji Eon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine , Seoul,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyungsub","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University College of Medicine , Daegu,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yonghoon","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine , Seoul,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae Seung","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine , Seoul,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ho Sung","family":"Son","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine , Seoul,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0311-6565","authenticated-orcid":false,"given":"Seung Hyun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hee Jung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine , Seoul,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,1,29]]},"reference":[{"key":"2025030423590298000_ezaf018-B1","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.athoracsur.2017.05.016","article-title":"Surgical ablation of atrial fibrillation in the United States: trends and propensity matched outcomes","volume":"104","author":"Badhwar","year":"2017","journal-title":"Ann Thorac Surg"},{"key":"2025030423590298000_ezaf018-B2","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1016\/0003-4975(93)90338-I","article-title":"Five-year experience with the maze procedure for atrial fibrillation","volume":"56","author":"Cox","year":"1993","journal-title":"Ann Thorac Surg"},{"key":"2025030423590298000_ezaf018-B3","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1016\/j.hrthm.2019.05.001","article-title":"Five-year outcomes in cardiac surgery patients with atrial fibrillation undergoing concomitant surgical ablation versus no ablation. 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