|
|
||||||||
Eur J Cardiothorac Surg 2000;18:182-186
© 2000 Elsevier Science NL
a Santa Cruz Hospital, Carnaxide, Portugal
b Heart Institute, Carnaxide, Portugal
Received 7 September 1999; received in revised form 26 April 2000; accepted 10 May 2000.
Corresponding author. Instituto do Coração, Av. Prof Reinaldo Santos 27, 2795 Carnaxide, Portugal. Tel.: +351-14-165-900; fax: +351-14-195-918
e-mail: jqmelo{at}hsc.min-saude.pt
Objective: Atrial fibrillation has been a difficult problem to solve in many surgical patients, especially in those with mitral valve pathology. This study evaluates the results of endocardial and epicardial radiofrequency ablation with a new intra-operative device in the treatment of atrial fibrillation. Methods: We operated on 65 patients with atrial fibrillation, 58 of which had concomitant mitral surgery. Atrial fibrillation was chronic (over 1 year) in 46 patients (group A) and paroxysmal or recent onset in 12 (group B). Group C had lone atrial fibrillation (two), concomitant coronary artery disease (four) or a sarcoma (one). Bilateral pulmonary vein isolation with a new intra-operative device was performed through multiple dry lesions in all patients. Groups A and B had endocardial applications at 70°C during 60 s and group C had epicardial applications at 75°C. Three group C patients had epicardial applications off pump. Atrial wall biopsies were performed in nine patients from groups A and B. Results: There were no serious post-operative complications. At 1 month follow-up 54% of all patients were out of atrial fibrillation and 34% were in normal sinus rhythm with bilateral atrial contraction (Santa Crus Score 4). At 6 months follow-up, in spite of some crossover of patients among groups, similar results were obtained. The success of the procedure was 69% (Santa Crus scores 3 and 4) in mitral patients with a left atrial volume smaller than 200 cm3. Preliminary data on the transmurality of the lesions is presented. The patients submitted to epicardial radiofrequency ablation (group C) have satisfactory results at 1 month (six out of seven were out of AF). Conclusions: Both endocardial and epicardial RF applications are simple and quick to perform and do not pose an additional risk for most patients. Furthermore we believe that it is possible to perform bilateral epicardial radiofrequency ablation of the pulmonary veins without cardiopulmonary bypass. Further refinements of the technique are needed to assure transmurality of all lesions and better results.
Key Words: Atrial fibrillation surgery Radiofrequency catheter ablation Pulmonary vein isolation Arrhythmia surgery Mitral valve surgery
This article has been cited by other articles:
![]() |
P. Jais, B. Cauchemez, L. Macle, E. Daoud, P. Khairy, R. Subbiah, M. Hocini, F. Extramiana, F. Sacher, P. Bordachar, et al. Catheter Ablation Versus Antiarrhythmic Drugs for Atrial Fibrillation: The A4 Study Circulation, December 9, 2008; 118(24): 2498 - 2505. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Vicol, D. Kellerer, P. Petrakopoulou, I. Kaczmarek, P. Lamm, and B. Reichart Long-term results after ablation for long-standing atrial fibrillation concomitant to surgery for organic heart disease: Is microwave energy reliable? J. Thorac. Cardiovasc. Surg., November 1, 2008; 136(5): 1156 - 1159. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. Melo, T. Santiago, C. Aguiar, E. Berglin, M. Knaut, O. Alfieri, S. Benussi, H. Sie, M. Williams, F. Hornero, et al. Surgery for atrial fibrillation in patients with mitral valve disease: Results at five years from the International Registry of Atrial Fibrillation Surgery. J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 863 - 869. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Deneke, K. Khargi, B. Lemke, T. Lawo, M. Lindstaedt, A. Germing, T. Brodherr, L. Bosche, A. Mugge, A. Laczkovics, et al. Intra-operative cooled-tip radiofrequency linear atrial ablation to treat permanent atrial fibrillation Eur. Heart J., December 1, 2007; 28(23): 2909 - 2914. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. M. Stulak, J. A. Dearani, T. M. Sundt III, R. C. Daly, C. G.A. McGregor, K. J. Zehr, and H. V. Schaff Superiority of cut-and-sew technique for the Cox maze procedure: Comparison with radiofrequency ablation J. Thorac. Cardiovasc. Surg., April 1, 2007; 133(4): 1022 - 1027. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Martin-Suarez, B. Claysset, L. Botta, M. Ferlito, D. Pacini, C. Savini, G. Marinelli, and R. DiBartolomeo Surgery for atrial fibrillation with radiofrequency ablation: four years experience Interactive CardioVascular and Thoracic Surgery, February 1, 2007; 6(1): 71 - 76. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Marui, T. Nishina, K. Tambara, Y. Saji, T. Shimamoto, M. Nishioka, T. Ikeda, and M. Komeda A novel atrial volume reduction technique to enhance the Cox maze procedure: initial results. J. Thorac. Cardiovasc. Surg., November 1, 2006; 132(5): 1047 - 1053. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. E. Saltman Must we cross the wall to get to the other side? J. Thorac. Cardiovasc. Surg., August 1, 2006; 132(2): 224 - 225. [Full Text] [PDF] |
||||
![]() |
J. Q. Melo Surgery for atrial fibrillation: Are we heading in the right direction? J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 949 - 951. [Full Text] [PDF] |
||||
![]() |
S. Benussi and O. Alfieri Concomitant ablation of atrial fibrillation during mitral surgery MMCTS, November 29, 2005; 2005(1129): 1081. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. E. Accord, R.-J. van Suylen, T. J. van Brakel, and J. G. Maessen Post-Mortem Histologic Evaluation of Microwave Lesions After Epicardial Pulmonary Vein Isolation for Atrial Fibrillation Ann. Thorac. Surg., September 1, 2005; 80(3): 881 - 887. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Benussi, S. Nascimbene, G. Calori, P. Denti, Z. Ziskind, S. Kassem, G. La Canna, C. Pappone, and O. Alfieri Surgical ablation of atrial fibrillation with a novel bipolar radiofrequency device J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 491 - 497. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. Bugge, I. A. Nicholson, and S. P. Thomas Comparison of bipolar and unipolar radiofrequency ablation in an in vivo experimental model Eur. J. Cardiothorac. Surg., July 1, 2005; 28(1): 76 - 80. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. E. Halkos, J. M. Craver, V. H. Thourani, F. Kerendi, J. D. Puskas, W. A. Cooper, and R. A. Guyton Intraoperative Radiofrequency Ablation for the Treatment of Atrial Fibrillation During Concomitant Cardiac Surgery Ann. Thorac. Surg., July 1, 2005; 80(1): 210 - 216. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. Fayad, T. Le Tourneau, T. Modine, R. Azzaoui, P.-V. Ennezat, C. Decoene, G. Deklunder, and H. Warembourg Endocardial Radiofrequency Ablation During Mitral Valve Surgery: Effect on Cardiac Rhythm, Atrial Size, and Function Ann. Thorac. Surg., May 1, 2005; 79(5): 1505 - 1511. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Geidel, J. Ostermeyer, M. Lass, M. Betzold, A. Duong, F. Jensen, S. Boczor, and K.-H. Kuck Three years experience with monopolar and bipolar radiofrequency ablation surgery in patients with permanent atrial fibrillation Eur. J. Cardiothorac. Surg., February 1, 2005; 27(2): 243 - 249. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. Bisleri, A. Manzato, M. Argenziano, D. W. Vigilance, and C. Muneretto Thoracoscopic epicardial pulmonary vein ablation for lone paroxysmal atrial fibrillation Europace, January 1, 2005; 7(2): 145 - 148. [Abstract] [Full Text] [PDF] |
||||
![]() |
J P Bourke, A Dunuwille, D O'Donnell, S Jamieson, and S S Furniss Pulmonary vein ablation for idiopathic atrial fibrillation: six month outcome of first procedure in 100 consecutive patients Heart, January 1, 2005; 91(1): 51 - 57. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. J. van Brakel, G. Bolotin, K. J. Salleng, L. W. Nifong, M. A. Allessie, W. R. Chitwood Jr, and J. G. Maessen Evaluation of Epicardial Microwave Ablation Lesions: Histology Versus Electrophysiology Ann. Thorac. Surg., October 1, 2004; 78(4): 1397 - 1402. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. Troise, M. Cirillo, F. Brunelli, G. Tasca, A. Amaducci, Z. Mhagna, M. Dalla Tomba, and E. Quaini Mid-term results of cardiac autotransplantation as method to treat permanent atrial fibrillation and mitral disease Eur. J. Cardiothorac. Surg., June 1, 2004; 25(6): 1025 - 1031. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. A. Romano, D. S. Bach, F. D. Pagani, R. L. Prager, G. M. Deeb, and S. F. Bolling Atrial reduction plasty Cox maze procedure: extended indications for atrial fibrillation surgery Ann. Thorac. Surg., April 1, 2004; 77(4): 1282 - 1287. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. Chiappini, S. Martin-Suarez, A. LoForte, G. Arpesella, R. Di Bartolomeo, and G. Marinelli Cox/Maze III operation versus radiofrequency ablation for the surgical treatment of atrial fibrillation: a comparative study Ann. Thorac. Surg., January 1, 2004; 77(1): 87 - 92. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. Chiappini, S. Martin-Suarez, A. LoForte, R. Di Bartolomeo, and G. Marinelli Surgery for atrial fibrillation using radiofrequency catheter ablation J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 1788 - 1791. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. Bonanomi, D. Schwartzman, D. Francischelli, K. Hebsgaard, and M. A. Zenati A new device for beating heart bipolar radiofrequency atrial ablation J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 1859 - 1866. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Laczkovics, K. Khargi, and T. Deneke Esophageal perforation during left atrial radiofrequency ablation J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 2119 - 2120. [Full Text] [PDF] |
||||
![]() |
L. Thomas, A. Boyd, S. P. Thomas, N. B. Schiller, and D. L. Ross Atrial structural remodelling and restoration of atrial contraction after linear ablation for atrial fibrillation Eur. Heart J., November 1, 2003; 24(21): 1942 - 1951. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. Raman, S. Ishikawa, M. M. Storer, and J. M. Power Surgical radiofrequency ablation of both atria for atrial fibrillation: results of a multicenter trial J. Thorac. Cardiovasc. Surg., November 1, 2003; 126(5): 1357 - 1365. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Santiago, J. Melo, R. H. Gouveia, J. Neves, M. Abecasis, P. Adragao, and A. P. Martins Epicardial radiofrequency applications: in vitro and in vivo studies on human atrial myocardium Eur. J. Cardiothorac. Surg., October 1, 2003; 24(4): 481 - 486. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. Khargi, T. Deneke, B. Lemke, and A. Laczkovics Irrigated radiofrequency ablation is a safe and effective technique to treat chronic atrial fibrillation Interactive CardioVascular and Thoracic Surgery, September 1, 2003; 2(3): 241 - 245. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. Jais, D.C. Shah, M. Hocini, L. Macle, K.-J. Choi, M. Haissaguerre, and J. Clementy Radiofrequency ablation for atrial fibrillation Eur. Heart J. Suppl., September 1, 2003; 5(suppl_H): H34 - H39. [Abstract] [PDF] |
||||
![]() |
B. Akpinar, M. Guden, E. Sagbas, I. Sanisoglu, U. Ozbek, B. Caynak, and O. Bayindir Combined radiofrequency modified maze and mitral valve procedure through a port access approach: early and mid-term results Eur. J. Cardiothorac. Surg., August 1, 2003; 24(2): 223 - 230. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Geidel, M. Lass, S. Boczor, K.-H. Kuck, and J. Ostermeyer Surgical treatment of permanent atrial fibrillation during heart valve surgery Interactive CardioVascular and Thoracic Surgery, June 1, 2003; 2(2): 160 - 165. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Santiago, J. Q. Melo, R. H. Gouveia, and A. P. Martins Intra-atrial temperatures in radiofrequency endocardial ablation: histologic evaluation of lesions Ann. Thorac. Surg., May 1, 2003; 75(5): 1495 - 1501. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. G. Demaria, P. Page, T. K. Leung, M. Dubuc, O. Malo, M. Carrier, and L. P. Perrault Surgical radiofrequency ablation induces coronary endothelial dysfunction in porcine coronary arteries Eur. J. Cardiothorac. Surg., March 1, 2003; 23(3): 277 - 282. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. L. Cox Intraoperative options for treating atrial fibrillation associated with mitral valve disease J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(90030): S24 - 27. [Full Text] [PDF] |
||||
![]() |
S. P. Thomas, D. J.R. Guy, A. C. Boyd, V. E. Eipper, D. L. Ross, and R. B. Chard Comparison of epicardial and endocardial linear ablation using handheld probes Ann. Thorac. Surg., February 1, 2003; 75(2): 543 - 548. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Hornero, J. A. Montero, S. Canovas, and M. Bueno Biatrial radiofrequency ablation for atrial fibrillation: epicardial and endocardial surgical approach Interactive CardioVascular and Thoracic Surgery, December 1, 2002; 1(2): 72 - 77. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. R. Williams, M. Knaut, D. Berube, and M. C. Oz Application of microwave energy in cardiac tissue ablation: from in vitro analyses to clinical use Ann. Thorac. Surg., November 1, 2002; 74(5): 1500 - 1505. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. S. Raman, S. Ishikawa, and J. M. Power Epicardial radiofrequency ablation of both atria in the treatment of atrial fibrillation: experience in patients Ann. Thorac. Surg., November 1, 2002; 74(5): 1506 - 1509. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Guden, B. Akpinar, I. Sanisoglu, E. Sagbas, and O. Bayindir Intraoperative saline-irrigated radiofrequency modified Maze procedure for atrial fibrillation Ann. Thorac. Surg., October 1, 2002; 74(4): S1301 - 1306. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. G. Maessen, J. F.M.A. Nijs, J. L.R.M. Smeets, J. Vainer, and B. Mochtar Beating-heart surgical treatment of atrial fibrillation with microwave ablation Ann. Thorac. Surg., October 1, 2002; 74(4): S1307 - 1311. [Abstract] [Full Text] [PDF] |
||||
![]() |
Y. A. Louagie, D. Blommaert, and L. De Roy Radiofrequency ablation of atrial flutter combined with closure of atrial septal defect Interactive CardioVascular and Thoracic Surgery, September 1, 2002; 1(1): 38 - 40. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. Ruchat, J. Schlaepfer, and L. K. von Segesser Off-pump epicardial compartmentalization for ablation of atrial fibrillation Interactive CardioVascular and Thoracic Surgery, September 1, 2002; 1(1): 55 - 57. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Deneke, K. Khargi, P. H. Grewe, S. von Dryander, F. Kuschkowitz, T. Lawo, K.-M. Muller, A. Laczkovics, and B. Lemke Left atrial versus bi-atrial maze operation using intraoperatively cooled-tip radiofrequency ablation in patients undergoing open-heart surgery: Safety and efficacy J. Am. Coll. Cardiol., May 15, 2002; 39(10): 1644 - 1650. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. Jais, R. Weerasooriya, D. C. Shah, M. Hocini, L. Macle, K.-J. Choi, C. Scavee, M. Haissaguerre, and J. Clementy Ablation therapy for atrial fibrillation (AF): Past, present and future Cardiovasc Res, May 1, 2002; 54(2): 337 - 346. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Pappone Atrial fibrillation--a curable condition? Eur. Heart J., April 1, 2002; 23(7): 514 - 517. [Full Text] [PDF] |
||||
![]() |
D. C. Kress, D. Krum, V. Chekanov, J. Hare, N. Michaud, M. Akhtar, and J. Sra Validation of a left atrial lesion pattern for intraoperative ablation of atrial fibrillation Ann. Thorac. Surg., April 1, 2002; 73(4): 1160 - 1168. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. Mazzitelli, C.-H. Park, K.-Y. Park, F. J. Benetti, and R. Lange Epicardial ablation of atrial fibrillation on the beating heart without cardiopulmonary bypass Ann. Thorac. Surg., January 1, 2002; 73(1): 320 - 321. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Pasic, P. Bergs, P. Muller, M. Hofmann, O. Grauhan, H. Kuppe, and R. Hetzer Intraoperative radiofrequency maze ablation for atrial fibrillation: the Berlin modification Ann. Thorac. Surg., November 1, 2001; 72(5): 1484 - 1491. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. S. Raman, S. Seevanayagam, M. Storer, and J. M. Power Combined endocardial and epicardial radiofrequency ablation of right and left atria in the treatment of atrial fibrillation Ann. Thorac. Surg., September 1, 2001; 72(3): S1096 - 1099. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. L. Cox Intraoperative options for treating atrial fibrillation associated with mitral valve disease J. Thorac. Cardiovasc. Surg., August 1, 2001; 122(2): 212 - 215. [Full Text] [PDF] |
||||
![]() |
M. R. Williams, J. R. Stewart, S. F. Bolling, S. Freeman, J. T. Anderson, M. Argenziano, C. R. Smith, and M. C. Oz Surgical treatment of atrial fibrillation using radiofrequency energy Ann. Thorac. Surg., June 1, 2001; 71(6): 1939 - 1944. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. T. Sie, W. P. Beukema, A. R. Ramdat Misier, A. Elvan, J. J. Ennema, and H. J.J. Wellens The radiofrequency modified maze procedure. A less invasive surgical approach to atrial fibrillation during open-heart surgery Eur. J. Cardiothorac. Surg., April 1, 2001; 19(4): 443 - 447. [Abstract] [Full Text] [PDF] |
||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |