Specific linear left atrial lesions in atrial fibrillation

Kottkamp, Hans; Hindricks, Gerhard; Autschbach, R; Krauss, Beate; Strasser, Bernhard; Schirdewahn, Petra; Fabricius, Alexander; Schuler, Gerhard; Mohr, Friedrich–Wilhelm

doi:10.1016/s0735-1097(02)01993-9

Cited by 164 publications

(21 citation statements)

References 18 publications

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“…As it is likely that electrical and/or structural remodelling affects multiple sites of the atria, the arrhythmogenic substrate of AF will not only be confined to the PV area. This hypothesis is supported by the outcome of the IRAAF study (The Intraoperative Radiofrequency Ablation of Atrial Fibrillation) [26]. In this study, creation of linear lesions in the left atrium without PVI eliminated AF in more than 90 % of the patients.…”

Section: Effects Of the Pulmonary Vein Isolation Proceduressupporting

confidence: 58%

Atrial fibrillation: to map or not to map?

et al. 2013

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Isolation of the pulmonary veins may be an effective treatment modality for eliminating atrial fibrillation (AF) episodes but unfortunately not for all patients. When ablative therapy fails, it is assumed that AF has progressed from a trigger-driven to a substrate-mediated arrhythmia. The effect of radiofrequency ablation on persistent AF can be attributed to various mechanisms, including elimination of the trigger, modification of the arrhythmogenic substrate, interruption of crucial pathways of conduction, atrial debulking, or atrial denervation. This review discusses the possible effects of pulmonary vein isolation on the fibrillatory process and the necessity of cardiac mapping in order to comprehend the mechanisms of AF in the individual patient and to select the optimal treatment modality.

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Section: Effects Of the Pulmonary Vein Isolation Proceduressupporting

confidence: 58%

Atrial fibrillation: to map or not to map?

et al. 2013

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“…The complications of unipolar RF devices have been described after extensive clinical use and include coronary artery injuries, cerebrovascular accidents, and the devastating creation of esophageal perforation, leading to atrioesophageal fistula. 27,39–42 …”

Section: Unipolar Radiofrequency Energymentioning

confidence: 99%

Ablation Technology for the Surgical Treatment of Atrial Fibrillation

Melby

Schuessler²,

Damiano³

2013

ASAIO Journal

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The Cox maze procedure for the surgical treatment of atrial fibrillation has been simplified from its original cut-and-sew technique. Various energy sources now exist which create linear lines of ablation that can be used to replace the original incisions, greatly facilitating the surgical approach. This review article describes the anatomy of the atria that must be considered in choosing a successful energy source. Furthermore the device characteristics, safety profile, mechanism of tissue injury, and ability to create transmural lesions of the various energy sources that have been used in the Cox maze procedure, along with the strengths and weaknesses of each device is discussed.

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“…A multitude of ablation devices have been used in the formation of these lesions sets, with varying techniques and varying degrees of success. 88,104,110–116 A meta-analysis by Barnett and Ad in 2006 showed a 73% success for left atrial lesion sets versus 87% for biatrial lesion sets (P = .05). 117 The only randomized control trial comparing the efficacy of left atrial lesion set versus no ablation procedure was reported by Doukas and colleagues.…”

Section: Other Af Proceduresmentioning

confidence: 99%