ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Nahush A. Mokadam
Patrick M. McCarthy
William H. Ryan
Marc R. Moon
Michael J. Mack
Sydney L. Gaynor
Sunil M. Prasad
Marci S. Bailey
Yosuke Ishii
Richard B. Schuessler
Ralph J. Damiano, Jr
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Mokadam, N. A.
Right arrow Articles by Damiano, R. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Mokadam, N. A.
Right arrow Articles by Damiano, R. J., Jr

Ann Thorac Surg 2004;78:1665-1670
© 2004 The Society of Thoracic Surgeons

ORIGINAL ARTICLE: CARDIOVASCULAR

A Prospective Multicenter Trial of Bipolar Radiofrequency Ablation for Atrial Fibrillation: Early Results

Nahush A. Mokadam, MDa, Patrick M. McCarthy, MDb, A. Marc Gillinov, MDb, William H. Ryan, MDc, Marc R. Moon, MDa, Michael J. Mack, MDc, Sydney L. Gaynor, MDa, Sunil M. Prasad, MDa, Samuel A. Wickline, MDa, Marci S. Bailey, RNa, Nicholas R. Damianoa, Yosuke Ishii, MDa, Richard B. Schuessler, PhDa, Ralph J. Damiano, Jr, MDa,*

a Division of Cardiothoracic Surgery, Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, Missouri, USA
b Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
c Cardiopulmonary Research Science and Technology Institute, Dallas, Texas, USA

Accepted for publication May 12, 2004.

* Address reprint requests to Dr Ralph Damiano, Division of Cardiac Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, One Barnes-Jewish Plaza, Suite 3108 Queeny Tower, St. Louis, MO 63110 (E-mail: damianor{at}msnotes.wustl.edu).

BACKGROUND: The Cox-Maze III remains the gold standard for the surgical treatment of atrial fibrillation. However, the "cut-and-sew" technique is time consuming and technically challenging. The pulmonary veins are the source of ectopy in the majority of patients with atrial fibrillation. The safety and efficacy of bipolar radiofrequency to electrically isolate the pulmonary veins was evaluated in a prospective multi-center trial.

METHODS: Beginning in January 2002, 30 patients at three medical centers underwent pulmonary vein isolation using bipolar radiofrequency and were followed for 6 months. Twenty-four of the patients also underwent a modified Cox-Maze III. Electrical isolation of the pulmonary veins was confirmed with intraoperative pacing. Pulmonary vein patency was assessed by magnetic resonance imaging or three-dimensional computed tomography in 15 patients at 1 month.

RESULTS: Mean age was 60.9 ± 11.7 years. Nineteen patients had paroxysmal atrial fibrillation. All pulmonary veins were isolated in every patient. The left pulmonary veins underwent 3.0 ± 1.4 applications for a total of 26.4 ± 10.5 seconds. The right pulmonary veins underwent 2.8 ± 1.1 applications for a total of 26.3 ± 12.6 seconds. There was no operative mortality. At 1 month, imaging revealed no evidence of pulmonary vein stenosis. At 6 months, 96% of patients were in normal sinus rhythm.

CONCLUSIONS: The use of bipolar radiofrequency for electrical isolation of pulmonary veins and to replace other Cox-Maze III incisions is safe and effective at controlling atrial fibrillation. This emerging technology may shorten and simplify the surgical management of atrial fibrillation.




This article has been cited by other articles:


Home page
 Eur. J. Cardiothorac. Surg.Home page
T. Funatsu, J. Kobayashi, H. Nakajima, Y. Iba, Y. Shimahara, and T. Yagihara
Long-term results and reliability of cryothermic ablation based maze procedure for atrial fibrillation concomitant with mitral valve surgery
Eur. J. Cardiothorac. Surg., August 1, 2009; 36(2): 267 - 271.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
R. K. Voeller, A. Zierer, S. C. Lall, S.-i. Sakamoto, N.-L. Chang, R. B. Schuessler, M. R. Moon, and R. J. Damiano Jr.
The effects of the Cox maze procedure on atrial function.
J. Thorac. Cardiovasc. Surg., November 1, 2008; 136(5): 1257 - 1264.e3.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
Y. Ishii, T. Nitta, M. Kambe, J. Kurita, M. Ochi, Y. Miyauchi, and K. Shimizu
Intraoperative verification of conduction block in atrial fibrillation surgery.
J. Thorac. Cardiovasc. Surg., October 1, 2008; 136(4): 998 - 1004.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
A. Yilmaz, B.P. Van Putte, and W.J. Van Boven
Completely thoracoscopic bilateral pulmonary vein isolation and left atrial appendage exclusion for atrial fibrillation.
J. Thorac. Cardiovasc. Surg., August 1, 2008; 136(2): 521 - 522.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
R. K. Voeller, M. S. Bailey, A. Zierer, S. C. Lall, S.-i. Sakamoto, K. Aubuchon, J. S. Lawton, N. Moazami, C. B. Huddleston, N. A. Munfakh, et al.
Isolating the entire posterior left atrium improves surgical outcomes after the Cox maze procedure.
J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 870 - 877.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
R. K. Voeller, R. B. Schuessler, and R. J. Damiano Jr.
Surgical Treatment of Atrial Fibrillation
Card. Surg. Adult, January 1, 2008; 3(2008): 1375 - 1394.
[Full Text]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
S. C. Lall, S. J. Melby, R. K. Voeller, A. Zierer, M. S. Bailey, T. J. Guthrie, M. R. Moon, N. Moazami, J. S. Lawton, and R. J. Damiano Jr
The effect of ablation technology on surgical outcomes after the Cox-maze procedure: A propensity analysis
J. Thorac. Cardiovasc. Surg., February 1, 2007; 133(2): 389 - 396.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
S. J. Melby, S. L. Gaynor, J. G. Lubahn, A. M. Lee, P. Rahgozar, S. D. Caruthers, T. A. Williams, R. B. Schuessler, and R. J. Damiano Jr
Efficacy and safety of right and left atrial ablations on the beating heart with irrigated bipolar radiofrequency energy: A long-term animal study
J. Thorac. Cardiovasc. Surg., October 1, 2006; 132(4): 853 - 860.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. Jahangiri, G. Weir, K. Mandal, I. Savelieva, and J. Camm
Current strategies in the management of atrial fibrillation.
Ann. Thorac. Surg., July 1, 2006; 82(1): 357 - 364.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
A. Itoh, J. Kobayashi, K. Bando, K. Niwaya, O. Tagusari, H. Nakajima, S. Komori, and S. Kitamura
The impact of mitral valve surgery combined with maze procedure.
Eur. J. Cardiothorac. Surg., June 1, 2006; 29(6): 1030 - 1035.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
S. D. Barnett and N. Ad
Surgical ablation as treatment for the elimination of atrial fibrillation: A meta-analysis
J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 1029 - 1035.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. C. Pruitt, R. R. Lazzara, G. H. Dworkin, V. Badhwar, C. Kuma, and G. Ebra
Totally Endoscopic Ablation of Lone Atrial Fibrillation: Initial Clinical Experience
Ann. Thorac. Surg., April 1, 2006; 81(4): 1325 - 1331.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
S. Benussi, S. Nascimbene, G. Calori, P. Denti, Z. Ziskind, S. Kassem, G. La Canna, C. Pappone, and O. Alfieri
Surgical ablation of atrial fibrillation with a novel bipolar radiofrequency device
J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 491 - 497.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2004 by The Society of Thoracic Surgeons.