HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Hiroshi Kubota Shinichi Takamoto Toshiya Ohtsuka Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kubota, H. Articles by Sudo, K. Search for Related Content PubMed PubMed Citation Articles by Kubota, H. Articles by Sudo, K.

Ann Thorac Surg 2004;78:1056-1059
© 2004 The Society of Thoracic Surgeons

---

New technology

Epicardial pulmonary vein isolation with a hook-shaped cryoprobe to treat atrial fibrillation

^a Department of Cardiovascular Surgery, University of Kyorin, Tokyo, Japan
^b Department of Cardiothoracic Surgery, University of Tokyo, Tokyo, Japan
^c Department of Cardiac Surgery, Tokyo Metropolitan Fuchu Hospital, Tokyo, Japan

Accepted for publication July 10, 2003.

^* Address reprint requests to Dr Kubota, Department of Cardiovascular Surgery, University of Kyorin, 6-20-2, Shinkawa, Mitaka-shi, Tokyo, 181-8611 Japan
kub{at}kyorin-u.ac.jp

Abstract

PURPOSE: After it was shown that a rapidly firing focus in a pulmonary vein (PV) can cause atrial fibrillation, percutaneous endocardial PV isolation using radiofrequency began to be used as a method of treatment. However, this technique is time consuming. It requires fluoroscopy and contrast media to identify the PV, and cardiac tamponade and PV obstruction are major complications. To overcome these drawbacks, we developed a hook-shaped cryoprobe to enable circumferential ablation of PV orifices epicardially. The aim of this experimental study in dogs was to confirm the efficacy of this method electrophysiologically.

DESCRIPTION: Five mongrel dogs (32 PVs) were used. Surrounding tissue was dissected to expose all PVs and their orifices into the left atrium. Each PV was stimulated with an electrode to measure the length of PV which has the same pacing threshold as the left atrium.

EVALUATION: The mean distance from the PV orifice to the pacing boundary line was 8.9 ± 1.3 mm. Encircling cryoablation was performed with a hook-shaped cryoprobe to circumferentially ablate each PV orifice epicardially.

CONCLUSIONS: Cryoablation by this method created a bidirectional conduction block in all PVs. All PVs were electrically isolated, and the PV isolation was achieved epicardially without atriotomy. This method should enable less invasive treatment of AF clinically.

This article has been cited by other articles:

				P. McKeown and A. E. Epstein Future Directions: American College of Chest Physicians Guidelines for the Prevention and Management of Postoperative Atrial Fibrillation After Cardiac Surgery Chest, August 1, 2005; 128(2_suppl): 61S - 64S. [Abstract] [Full Text] [PDF]

				M. M. Scheinman and E. Keung The year in clinical electrophysiology J. Am. Coll. Cardiol., March 1, 2005; 45(5): 790 - 795. [Full Text] [PDF]