Pulmonary Veins Epicardial Isolation with High-Intensity Focused Ultrasounds for the Treatment of Non-Primary Atrial Fibrillation

Abstract

Background: Atrial fibrillation (AF) can be treated surgically by using high intensityfocused ultrasounds as an energy source with the Epicor system. The objectives of the present study are: first, to evaluate the effectiveness and safety of that technique at one year of follow-up; second, to establish the differences of the results depending on whether AF is paroxysmal or chronic and third, according to the underlying heart disease.

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?

“…Nevertheless, there is a possibility that these good outcomes may have been a result of inadequate diagnostic measures to detect short periods of AF during follow-up, since some studies did not perform Holter ECG assessment, or implantation of event loop recorders in patients who underwent epicardial AF ablation. Romero-Ferrer B et al [14] also followed the heart rhythm of their ablated patients with conventional surface electrocardiograms only. Therefore, it is possible that the incidence of patients in sinus rhythm may have been overestimated [14].…”

“…Romero-Ferrer B et al [14] also followed the heart rhythm of their ablated patients with conventional surface electrocardiograms only. Therefore, it is possible that the incidence of patients in sinus rhythm may have been overestimated [14].…”

“…In this issue of the Journal of Cardiology and Current Research, Romero-Ferrer B et al [14] evaluated the effectiveness and safety of pulmonary veins epicardial ablation in AF patients during open heart surgery. They divided their patients into two groups, one with 20 patients with paroxysmal AF and another with 39 chronic AF.…”

“…No significant differences were found according to the underlying disease or the type of AF, although the results were better when AF was paroxysmal. There were no technique-related serious complications [14]. The authors concluded that epicardial surgical ablation of the pulmonary veins with high-intensity focused ultrasounds is safe and shows good results, especially in patients with paroxysmal AF, regardless of their underlying heart disease, and it should be offered when there is a surgical indication for their cardiac illness [14].…”

“…The detected success rates ranged from 65% to 90% using this energy source [12]. In their study, Romero-Ferrer B et al [14] observed that 65.3% of their patients were in sinus rhythm at one year of follow-up. Their results are in accord with previous studies.…”