A prospective, single-center clinical trial of a modified Cox maze procedure with bipolar radiofrequency ablation

Abstract

Bipolar radiofrequency ablation can be used to replace the surgical incisions of the Cox maze procedure. This energy source did not result in pulmonary vein stenosis. The modification of the Cox maze III procedure to use bipolar radiofrequency ablation simplified and shortened this procedure without sacrificing short-term efficacy.

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

“…A number of groups have reported excellent results with ablation-assisted Cox-Maze procedures. 1301,1302,1303,1304,1305,1306 …”

Surgery for Atrial Fibrillation

“…53,54 Early follow-up suggests that the Cox-Maze IV procedure is similar in efficacy with 91% of patients having freedom from AF at 6 months. 55 There was no operative mortality and the group had significantly shorter cross clamp time compared to the Cox Maze III group. Cox also suggested another simplified procedure to cure most patients of AF.…”

High Intensity Focused Ultrasound Atrial Fibrillation Ablation during Concomitant Open Heart Surgery: Is it Time to Offer this Procedure to any Patient Undergoing Cardiac Surgery?

“…Not treated preoperative atrial fibrillation was also associated with increased late cardiac morbidity and mortality, and poor long-term survival [3][4][5]. Surgical conventional atrial lesions are generally created under cardiopulmonary bypass after opening the left atrium with the utilization of different energy sources [6][7][8][9][10]. The surgically performed ablation lines done with radiofrequency, microwave, or laser energy sources were designed to closely replicate the original lesion set described by James L. Cox for a successful treatment of AF, but without the operative time and morbid cost of the classic cut and sew Maze procedure [11].…”