Epicardial electrical isolation of the right atrial appendage on the beating heart with an infrared coagulator.

To determine the clinical efficacy of application of infrared energy to the beating heart as a means of creating electrical blocks, an original infrared coagulator (KIRC-119; Phomec Inc, Tokyo, Japan) was applied to the atrium of a patient with atrial fibrillation. A postoperative electrophysiologic study was performed to confirm its efficacy. The coagulator was applied epicardially to the beating heart concomitant with an on-pump beating heart coronary artery bypass graft procedure. Sinus rhythm was restored during the operation, and the electrophysiologic study revealed that a bidirectional block had been created on the right atrial appendage. The infrared coagulator may facilitate performance of the epicardial Maze procedure on the beating heart.