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DOI: 10.1055/s-2002-32411
© Georg Thieme Verlag Stuttgart · New York
Left Atrial Radiofrequency Compartmentalization for Chronic Atrial Fibrillation during Heart Surgery
Publikationsverlauf
Publikationsdatum:
21. Juni 2002 (online)
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Introduction
Atrial fibrillation (AF) is the most common sustained clinical arrhythmia, and is associated with higher morbidity and mortality compared to the general population [1]. AF becomes increasingly common with age [2], and is responsible for substantial hospital costs. In patients with chronic AF and valvular disease, arrhythmia usually persists after successful surgical correction of the underlying pathology [3]. Besides restoration of sinus rhythm (SR), a curative surgical treatment of AF has to achieve normalization in the atrial hemodynamics and a decrease in thromboembolic risks without the need for systemic anticoagulation. After many years of experimental work on the Maze procedure, Cox et al. succeeded in developing a method of surgical treatment of AF which solves these problems [4]. The main principle of the Maze operation is the ablation of all potential re-entrant circuits by multiple atrial incisions. Several modifications have been developed to the original procedure ending-up in the so-called maze-III. Recently, Sueda [5] presented excellent results with an exclusive left atrial ablation in addition to mitral valve procedures. Melo [6] and Kottkamp [7] reduced the pattern to bilateral pulmonary vein isolation and ablation of anatomic re- entrant circuits by temperature controlled radiofrequency.
We therefore applied a new, simplified RF ablation approach to compartmentalize the left atrium as a modification of the Maze procedure. This was performed in addition to the primarily planned cardiac surgical interventions.
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Dr. Patrick Ruchat
Service de Chirurgie Cardio-Vasculaire, Centre Hospitalier Universitaire Vaudois
Rue du Bugnon 46
1011 Lausanne
Switzerland
Telefon: + 41(21)3142280
Fax: + 41(21)3142278
eMail: Patrick.Ruchat@chuv.hospvd.ch