title: Evaluation of a novel epicardial atrial fibrillation treatment system.
abstract: OBJECTIVE
  Surgical and catheter treatments for atrial fibrillation remain invasive or ineffective for most patients. A novel system developed to create epicardial ablation lesions during beating-heart surgical procedures was evaluated in an in vivo ovine model.
  
  
  METHODS
  This novel ablation device integrates radiofrequency, suction, and perfusion to create transmural lesions by remaining consistently in contact with the irregular and curved surface of the beating heart.
  
  
  RESULTS
  Two epicardial ablation patterns were generated in five adult sheep: left atrial appendage and left pulmonary vein isolation. The 2-cm and 5-cm coagulation devices generated linear and curved lesions and maintained intimate contact against the epicardium using suction. Significant increases in bipolar pacing thresholds demonstrated trans-lesion conduction block in all animals. Histopathologic examination verified transmurality and showed changes normally observed after coagulation procedures. All lesions demonstrated mural degeneration throughout the lesion. No charring, vaporization, thromboembolic events, nor other complications were observed.
  
  
  CONCLUSIONS
  This novel epicardial coagulation system successfully created continuous and transmural atrial lesions in a beating-heart ovine model.
authors.affiliation: Division of Cardiothoracic Surgery, Pinehurst Surgical, Pinehurst, North Carolina 28374, USA. akiser@pinehurstsurgical.com
authors.forename: Andy C
authors.initials: AC
authors.lastname: Kiser
authors.forename: L Wiley
authors.initials: LW
authors.lastname: Nifong
authors.forename: Jai
authors.initials: J
authors.lastname: Raman
authors.forename: Vigneshwar
authors.initials: V
authors.lastname: Kasirajan
authors.forename: Nigel
authors.initials: N
authors.lastname: Campbell
authors.forename: W Randolph
authors.initials: WR
authors.lastname: Chitwood
mesh_terms: D000818:Animals; D001281:Atrial Fibrillation / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods; D004195:Disease Models, Animal; D004867:Equipment Design; D004869:Equipment Safety; D007150:Immunohistochemistry; D017075:Laser Coagulation / Q000295:instrumentation; D010496:Pericardium / Q000601:surgery; D011667:Pulmonary Veins / Q000473:pathology / Q000601:surgery; D012680:Sensitivity and Specificity; D012756:Sheep