Bipolar irrigated radiofrequency ablation of the posterior-inferior left atrium and coronary sinus is feasible and safe.
BACKGROUND
Success of surgical therapy for atrial fibrillation (AF) mainly depends on creating a complete set of transmural atrial lesions. The established Cox procedures may be simplified by dropping lesions, but not without the risk of impaired results. We aimed to create a complete set of lesions using bipolar irrigated radiofrequency including ablation of the posterior-inferior left atrium (LA) and coronary sinus. Feasibility and safety were investigated.


METHODS
Six patients (mean age 63 +/- 14 years) with continuous AF (duration 15 +/- 8 months) underwent elective heart surgery for isolated mitral valve procedures (n = 4), in combination with myocardial revascularization (n = 1) or isolated bypass surgery (n = 1). Ablation of AF was performed using bipolar irrigated radiofrequency to create a modified Cox minimaze pattern.


RESULTS
No major intraoperative or postoperative complication occurred. Two patients left the operating room in sinus rhythm and 4 in junctional rhythm with atrioventricular pacing. AF ablation required 20 +/- 5 minutes.


CONCLUSIONS
Bipolar irrigated radiofrequency ablation including ablation of the posterior-inferior LA and coronary sinus is feasible and can be performed safety. Long-term studies in large patient cohorts are necessary to show efficiency of this method.
Vicol
Calin
C
Department of Cardiac Surgery, Grosshadern Medical Center, Ludwig-Maximilians-University Munich, Munich, Germany. Calin.Vicol@med.uni-muenchen.de
Kur
Felix
F
Eifert
Sandra
S
Oberhoffer
Martin
M
Nollert
Georg
G
Wintersperger
Bernd
B
Reichart
Bruno
B
D015502:Absorptiometry, Photon / Q000009:adverse effects / Q000379:methods*; D002346:Carotid Sinus / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006325:Heart Atria / Q000601:surgery*; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D016896:Treatment Outcome