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Eur J Cardiothorac Surg 2004;26:742-746
© 2004 Elsevier Science NL
a Department of Cardiac Surgery, Heart Center Dresden, University of Technology, Fetscherstr. 76, D-01307 Dresden, Germany
b Institute for Heart and Circulation Research, Hoyerswerda, Germany
Received 31 March 2004; received in revised form 8 June 2004; accepted 9 June 2004.
* Corresponding author. Tel.: +49-351-450-1800; fax: +49-351-450-1707
e-mail: monika.weber.hkz_dd{at}t-online.de
Objective: Microwave ablation (MW) has been established as a safe and efficient procedure for the treatment of permanent atrial fibrillation (pAF) resulting in conversion to sinus rhythm (SR). For further improvement of clinical results, a new ablation line concept has been introduced. We present the first clinical results using this new concept in comparison with the results of previous ablation line concepts. Methods: Ablation lines were performed using microwave energy (Flex 2 and Flex 4 device). We compared two groups, including patients (pts) with mitral valve disease (MVD), coronary artery disease (CAD), and aortic valve disease (AVD). Group A included 137 patients, age 68.4±7.8, with ejection fraction 32–80%, left atrial diameter 52.6±9.6 mm, suffering from MVD (n=87), CAD (n=59), or AVD (n=17) with pAF for 6.5±9.2 years using the original ablation line concept. Group B included 112 patients, age 68.1±8.0, ejection fraction 20–83%, left atrial diameter 53.1±8.7 mm with pAF for 6.8±7.0 years suffering from MVD (n=72), CAD (n=33) or AVD (n=36) performing a modified ablation line. Results: Survival rate of group A was 98.5% and 97.3% in group B. In the 6-month follow-up for group A, 62% of patients with MVD, 68% with CAD and 78% with AVD were in SR. For group B, 88% of patients with MVD, 78% with CAD and 85% with AVD were in SR. Conclusions: MW has become an efficient option with an excellent benefit/risk ratio for the treatment of pAF in patients with other cardio surgical disease. The modified ablation line concept in association with the introduction of a new ablation catheter resulted in a 10% higher success rate. Therefore we have established this new lesion line concept as our standard for microwave ablation.
Key Words: Endocardial microwave ablation • Lesion line modification • Permanent atrial fibrillation
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