Efficacy of Three Different Ablative Procedures to Treat Atrial Fibrillation in Patients with Valvular Heart Disease: A Randomised Trial

Surgical ablation for treatment of atrial fibrillation in cardiac surgery: a cumulative meta-analysis of randomised controlled trials

“…Seven studies had >50 patients,19 22 – 24 27 28 44 while the remaining studies had less than 50 patients 18 20 21 25 26 29 30 33 34. Six studies used radiofrequency ablation,18 19 22 27 29 30 four studies used Cox–Maze CS,20 21 24 25 three studies used cryoablation,23 28 44 five studies reported patients undergoing pulmonary vein isolation,20 21 24 28 44 and two studies used microwave ablation 26 34. Results for coronary artery bypass grafting (CABG) were reported in eight studies,22 23 25 26 29 33 34 44 while valvular surgery was studied in all RCTs except Pokushalov et al 33…”

Feasibility of in vivo Transesophageal Cardiac Ablation Using a Phased Ultrasound Array

“…There may be inter-animal differences that result in differing lesion sizes. As seen in other ablation procedures like the Maze procedure (Backer et al 2008;Cox et al 1991;Gillinov and Saltman 2008;Srivastava et al 2008), several lesions were identified both on swine heart ventricles and atria.…”

“…Catheters that deliver radio-frequency energy are placed centrally to lie within the atria to ablate myocardial tissue. Surgical procedures like the Maze procedure require thoracotomy and open heart cardiopulmonary bypass surgery to allow a surgeon access to the heart to cut directly into the atria (Backer et al 2008;Cox et al 1991;Gillinov and Saltman 2008;Srivastava et al 2008). Ablation and surgical procedures cause scar tissue within the atrial muscle that forms a barrier to electrical activity.…”

Surgical Management of Atrial Fibrillation

“…As the authors mention, this is likely the result of 1) sinus restoration, 2) preservation of atrial transport function and 3) removal or obliteration of the LAA. A single center trial comparing patients undergoing mitral valve replacement or repair demonstrated improved conversion to sinus rhythm with concurrent modified radiofrequency maze ablation versus medical treatment (75% vs 39%) at 1 year follow-up (57 (63). Although these clinical trials are relatively small single center experiences with short-term follow up times, they demonstrate a consistent improvement in sinus rhythm restoration regardless of the underlying MV pathology and procedure used including maze III, Left Maze, Maze with alternative energy sources and PVI.…”