AIM: Several tools have been invented for surgical atrial fibrillation (AF) ablation. In this study, we investigated the real world efficacy of intraoperative AF ablation (AFA) with radiofrequency-energy or cryo-ablation and performed an electro-anatomical remap in some patients with recurrences. METHODS: Seventy-three consecutive patients (53 male, median age of 69 ± 7 years) with history of AF underwent cardiac surgery for valve repair (74 % mitral defects, 60 % aortic defects) and/or coronary artery bypass graft procedures (56 %). During a follow-up of 23 ± 11 months after AFA we performed intensified holter-monitoring (4-7 days). Patients with symptomatic relapse of atrial arrhythmias (AA) were offered the opportunity for additional electrophysiological examination (EPE). RESULTS: During 23 ± 11 months after AFA, 45 patients (62 %) had recurrent AA. In eight patients we performed EPE. In all 8 cases, septal circumferential lesions could be demonstrated during mapping with discrete gaps. All lateral veins were isolated however, posteriorly deep inside the vein leaving the antral region completely untreated. Neither roof lines nor mitral isthmus lines were complete. Performing catheter ablation, all veins could be isolated and seven patients were free of any arrhythmias during follow up (9 ± 5 months) without taking antiarrhythmic drugs. CONCLUSION: Surgical AF ablation may often be incomplete rendering sobering results in unselected patients. Completion of the ablation is feasible with catheter ablation with good clinical outcome.
AIM: Several tools have been invented for surgical atrial fibrillation (AF) ablation. In this study, we investigated the real world efficacy of intraoperative AF ablation (AFA) with radiofrequency-energy or cryo-ablation and performed an electro-anatomical remap in some patients with recurrences. METHODS: Seventy-three consecutive patients (53 male, median age of 69 ± 7 years) with history of AF underwent cardiac surgery for valve repair (74 % mitral defects, 60 % aortic defects) and/or coronary artery bypass graft procedures (56 %). During a follow-up of 23 ± 11 months after AFA we performed intensified holter-monitoring (4-7 days). Patients with symptomatic relapse of atrial arrhythmias (AA) were offered the opportunity for additional electrophysiological examination (EPE). RESULTS: During 23 ± 11 months after AFA, 45 patients (62 %) had recurrent AA. In eight patients we performed EPE. In all 8 cases, septal circumferential lesions could be demonstrated during mapping with discrete gaps. All lateral veins were isolated however, posteriorly deep inside the vein leaving the antral region completely untreated. Neither roof lines nor mitral isthmus lines were complete. Performing catheter ablation, all veins could be isolated and seven patients were free of any arrhythmias during follow up (9 ± 5 months) without taking antiarrhythmic drugs. CONCLUSION: Surgical AF ablation may often be incomplete rendering sobering results in unselected patients. Completion of the ablation is feasible with catheter ablation with good clinical outcome.
Authors: Simon Maltais; Jessica Forcillo; Denis Bouchard; Michel Carrier; Raymond Cartier; Philippe Demers; Louis P Perrault; Nancy Poirier; Martin Ladouceur; Pierre Pagé; Michel Pellerin Journal: J Card Surg Date: 2010-09 Impact factor: 1.620
Authors: Spencer J Melby; Andreas Zierer; Marci S Bailey; James L Cox; Jennifer S Lawton; Nabil Munfakh; Traves D Crabtree; Nader Moazami; Charles B Huddleston; Marc R Moon; Ralph J Damiano Journal: Ann Surg Date: 2006-10 Impact factor: 12.969
Authors: A Harada; K Sasaki; T Fukushima; M Ikeshita; T Asano; S Yamauchi; S Tanaka; T Shoji Journal: Ann Thorac Surg Date: 1996-01 Impact factor: 4.330
Authors: Ali J Khiabani; Taylan Adademir; Richard B Schuessler; Spencer J Melby; Marc R Moon; Ralph J Damiano Journal: Innovations (Phila) Date: 2018 Nov/Dec