Objectives: Maze operation is known to be effective for the restoration and maintenance of sinus rhythm in atrial fibrillation (AF) after cardiac surgery. But, in some cases, sinus rhythm could not be restored and abnormal rhythms including AF or atrial flutter (AFL) might persist. Our aim was to identify the relationship of preoperative parameters with the recurrence of atrial arrhythmia after Maze operation. Methods: Prospectively, we evaluated 54 patients who underwent cardiac surgery with a modified Cox-III Maze operation. Mean age was 53.5짹11.5 years. Laboratory tests including plasma N-terminal B-type natriuretic peptide (BNP) and C-reactive proteins (hsCRP), and echocardiography including measurement of left atrial (LA) dimension and LA volume (LAV) index were performed preoperatively. Mitral inflow and annular velocities were measured by Doppler and tissue Doppler image during immediate postoperative periods. Serial ECGs were taken to monitor the development of arrhythmias during follow-up (F/U). Results: Sinus rhythm was restored and maintained in 30(55.6%) patients during mean 6.6짹3.8 month F/U. AF or AFL was noted in 25(46.3%) patients during entire F/U period. Early postoperative (<1 month) AF/AFL was noted in 23(42.6%) patients whereas late recurrence (>1 month) or persistence of AF/AFL was noted in 16 (29.6%). Other supraventricular arrhythmias such as accelerated junctional rhythms were noted in 12(22.2%) patients after 1 month of surgery. Persistent AF throughout F/U period was noted in 6(11.1%) patients. Old age, LAV index and AF during immediate postoperative periods were related to persistent AF; odd ratios (OR) were 1.09, 1.05 and 9.55 with statistical significances (p=0.034, 0.008 and 0.011). But, the duration of AF, Doppler and tissue Doppler parameters, plasma BNP and hsCRP levels were not related to recurrence of AF. LAV index and early postoperative AF were also related to supraventricular arrhythmia other than AF/AFL(OR=1.04, p=0.006 and OR=7.33, p=0.01 respectively). Conclusions: After Maze operation, old age, LAV index and early postoperative AF may be considered as clinical predictors of various supraventricular arrhythmias including persistent AF.