The CURE-AF trial: A prospective, multicenter trial of irrigated radiofrequency ablation for the treatment of persistent atrial fibrillation during concomitant cardiac surgery

The ABLATE Trial: Safety and Efficacy of Cox Maze-IV Using a Bipolar Radiofrequency Ablation System

“…A study that is particularly comparable to the present one in terms of patient population is The Concomitant Utilization of Radio Frequency Energy for Atrial Fibrillation (CURE-AF) trial [16], which evaluated the efficacy and safety of the Medtronic Cardioblate surgical ablation system. Its fractions of paroxysmal, persistent, and long-standing persistent AF were similar to those of the ABLATE trial, and the concomitant surgical procedures similarly complex.…”

Sinus Rhythm Restoration after Radiofrequency Ablation Improves Survival in Patients Undergoing Mitral Valve Surgery : A Eight Year Single Center Study

“…[13] In previous studies preoperative LA size, cardiothoracic ratio over 60%, fine AF wave at preoperative ECG, and no early sinus rhythm restoration, an increasing number of concomitant surgeries were reported as independent predictors of ablation failure in the intermediate follow-up period at multivariate analysis. [14]- [16], [18] An elevated mean-age of patients, the absence of paroxysmal AF and a high percentage of rheumatic valve disease may explain the relative high rate (26%) of persistence of AF at hospital discharge observed in present investigation. Atrial fibrosis [19] may be responsible for the poor results of RF ablation in rheumatic heart disease.…”

Minimally invasive surgery for atrial fibrillation

“…Bipolar RF clamps are used to create most of the ablation lines of the CMIV procedure because they safely create rapid, consistently transmural lesions in both animals and humans (14,15). Several commercially available bipolar RF clamps have been specifically adapted for minimally invasive applications, such as the Isolator Synergy ENDO and Access clamps (AtriCure, Inc.) and the Cardioblate Gemini (Medtronic, Inc.) ( Figure 1).…”

“…Except in the case of the circumferential pulmonary vein ablations, bipolar RF clamps require access to both the epicardial and endocardial surface to create a transmural lesion, which is achieved in the CMIV procedure by inserting one jaw of the clamp inside the atria through a pursestring suture or an incision (15). This maneuver requires the use of cardiopulmonary bypass to prevent bleeding or air entrapment that could otherwise result from making an atriotomy on the beating heart.…”