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Eur J Cardiothorac Surg 2003;24:475-480
© 2003 Elsevier Science NL

Surgical treatment of permanent atrial fibrillation using microwave energy ablation: a prospective randomized clinical trial

A. Schuetza,1, C.J. Schulzea,1, K.K. Sarvanakisa, H. Maira, H. Plazera, E. Kilgerb, B. Reicharta, S.M. Wildhirta*

a Department of Cardiac Surgery, Heart Center Augustinum, Ludwig-Maximillians University, Wolkerweg 16, D-81375 Munich, Germany
b Department of Anesthesiology, Heart Center Augustinum, Ludwig-Maximillians University, Munich, Germany

Received 3 March 2003; received in revised form 28 May 2003; accepted 29 May 2003.

* Corresponding author. Present address: Department of Cardiac Surgery, University of Munich, Heart Center Augustinum,Wolkerweg 16, 81375 Munich, Germany. Tel.: +49-89-7097-1817; fax: +49-89-7097-1848
e-mail: wildhirt{at}gmx.net

Objective: Radiofrequency or the use of microwave energy in combination with atrial size reduction during open heart surgery have been reported to be effective in up to 75% in the treatment of permanent atrial fibrillation. However, no data from prospective randomized trials using microwave energy are available. Methods: Forty-three patients with permanent atrial fibrillation undergoing open-heart surgery were randomly stratified into treatment group receiving microwave ablation and atrial size reduction (n=24) or control group (n=19). Patients in either group were treated with amiodarone or sotalol for 3 months if sinus rhythm or any atrioventricular rhythm was successfully restored. Follow-up time points were at 3, 6 and 12 month after surgery. Results: In the treatment group 22 out of 24 patients (91,7%) were successfully converted to sinus rhythm by using intraoperative microwave ablation therapy whereas only six out of 19 (31.5%) patients converted to sinus rhythm directly after surgery. At 12-month follow-up there were still a significantly higher percentage of patients in the treatment group free from atrial fibrillation when compared to control (80 vs. 33.3%, P=0.036). Conclusion: The preliminary data from this first prospectively randomized trial indicate that microwave ablation combined with atrial size reduction is a safe and highly efficient treatment in permanent atrial fibrillation.

Key Words: Microwave ablation • Cardiac surgery • Atrial fibrillation




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