Surgical ablation of atrial fibrillation using the epicardial radiofrequency approach: mid-term results and risk analysis

Benussi, Stefano; Nascimbene, Simona; Agricola, Eustachio; Calori, Giliola; Calvi, Simone; Caldarola, Alessandro; Oppizzi, Michele; Casati, Valter; Pappone, Carlo; Alfieri, Ottavio

doi:10.1016/s0003-4975(02)03850-x

Cited by 100 publications

(73 citation statements)

References 26 publications

(18 reference statements)

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“…All patients underwent radiofrequency ablation and mitral-valve repair surgery as previously described in detail by Benussi et al [5,6]. Briefly, two encircling lesions around the ostia of the pulmonary veins were carried out epicardially, using a temperature-controlled multipolar radiofrequency catheter (Therma Line, Boston Scientific).…”

Section: Caf-mvd Patientsmentioning

confidence: 99%

Regional left atrial interstitial remodeling in patients with chronic atrial fibrillation undergoing mitral-valve surgery

et al. 2004

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Ablation of the left atrial free wall around the pulmonary vein ostia (LAFW) may be effective in the treatment of chronic atrial fibrillation associated with mitral disease (CAF-MVD). Using light and conventional electron microscopy analyses, we wanted to evaluate, in CAF-MVD, the interstitial remodeling in the LAFW as well as in a more remote region, such as the left atrial appendage (LAA). LAFW and LAA samples were obtained from 33 CAF-MVD patients during combined mitral surgery and radiofrequency ablation and from 16 autoptic controls. Interstitial fibrosis (IF) and perivascular fibrosis (PF), capillary densities and the maximal oxygen diffusion distance were morphometrically determined. In CAF-MVD patients, the LAFW, compared with the LAA, showed a higher percentage of IF (7.16+/-3.23% versus 2.51+/-1.40%, respectively), a lower myocardial capillary density per mm(2) (830+/-106 versus 989+/-173) and an increased oxygen maximal diffusion distance (19.70+/-1.27 microm versus 18.13+/-1.58 microm). All these values were also significantly different than controls. No differences were found in evaluating PF. At variance with the LAA, in CAF-MVD patients, the LAFW around the pulmonary vein ostia is a region characterized by a marked interstitial remodeling such that it may be morphologically indicated as an appropriate target for ablation treatment aimed at sinus rhythm restoration.

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Section: Caf-mvd Patientsmentioning

confidence: 99%

Regional left atrial interstitial remodeling in patients with chronic atrial fibrillation undergoing mitral-valve surgery

et al. 2004

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“…The reasons for failure of the method are still unknown exactly. [10][11][12][13][14] The Epicor Medical approach, using therapeutic ultrasound in form of high intensity focused ultrasound (HIFU) applied on the epicardial side of the left atrium (LA) is a safe and effective energy source that allows surgeons to replicate the mini-maze lesion set precisely on a beating heart. 15) In our single experience study were evaluated the clinical long-term outcomes (ranging to 4 years) after HIFU ablation during concomitant cardiac surgery, the significance of postablation antiarrhythmic drug (AAD) therapy, the safety and efficacy of UltraWand and the assessment of predictors for a successfully restoration of sinus rhythm (SR).…”

Section: Introductionmentioning

confidence: 99%

Impact of Medical Treatment on Long-Term Results after Surgical Ablation of Atrial Fibrillation in Cardiac Surgical Patients

Feyrer¹,

Ballazhi²,

Seitz³

et al. 2014

ATCS

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Background: The aim of this study was to evaluate the long-term outcome (4 years) of high-intensity-focused-ultrasound (HIFU) cardiac ablation, the significance of postablation antiarrhythmic drugs (AADs) and predictors of successful sinus rhythm (SR) restoration. Methods: 103 patients were prospectively enrolled in a single-center study. The preoperative atrial fibrillation (AF) type was paroxysmal in 36%, permanent in 53%, persistent in 5% and flutter in 6% patients. The left atrial diameter was <50 mm in 78 patients and >50 mm in 25. Long-term results, up to 4 years, and postablation antiarrhythmics were evaluated.

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“…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].…”

Section: Editorialmentioning

confidence: 99%

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?

2017

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Surgical ablation of atrial fibrillation using the epicardial radiofrequency approach: mid-term results and risk analysis

Cited by 100 publications

References 26 publications

Regional left atrial interstitial remodeling in patients with chronic atrial fibrillation undergoing mitral-valve surgery

Regional left atrial interstitial remodeling in patients with chronic atrial fibrillation undergoing mitral-valve surgery

Impact of Medical Treatment on Long-Term Results after Surgical Ablation of Atrial Fibrillation in Cardiac Surgical Patients

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?

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