[Surgical treatment for atrial fibrillation using ablation devices and ablation of autonomic ganglion plexi].
BACKGROUND
Development of ablation device for the surgical treatment for atrial fibrillation (Af) has suggested the safety and easiness of the maze procedure. However, the success rate of sinus rhythm (SR) recovery is not satisfactory. We studied the maze procedure and the results with ablation device and also with additional ganglion plexi (GP) ablation.


METHODS
Since April in 2002, 269 patients received maze operation with ablation device. The etiology was valvular disease in 196, ischemic heart disease in 18, dilated cardiomyopathy (DCM) in 36, and others in 19. The full maze operation with ablation devices and cryoablation was performed in principle and monopolar ablation devices were used in early phase and the bipolar ablation device was applied thereafter. The 73 patients after October in 2007 were divided into 44 patients with simultaneous GP ablation and 29 patients without GP ablation and the recovery rate of SR was compared in the 2 groups.


RESULTS
There were 7 hospital deaths (5 in DCM and 2 in valve disease). After the operation, 79% of the patients with monopolar devices and 75% of the patients with bipolar device were in SR. Among them, 88% of the patients with simultaneous GP ablation were in SR and no major complication.


CONCLUSIONS
The full maze operation with bipolar ablation and cryoablation showed minimal operative risk and concomitant GP ablation improved the SR recovery rate after the operation.
Isomura
Tadashi
T
Department of Cardiovascular Surgery, Hayama Heart Center, Kanagawa, Japan.
Hoshino
Jyoji
J
Fukada
Yasuhisa
Y
Kataoka
Shintaro
S
Kitamura
Aki
A
Kondou
Taichi
T
Iwasaki
Tomoaki
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002311:Cardiomyopathy, Dilated / Q000150:complications; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods; D003452:Cryosurgery; D005260:Female; D005725:Ganglia, Autonomic / Q000601:surgery*; D006349:Heart Valve Diseases / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications; D011667:Pulmonary Veins / Q000601:surgery; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*