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Ann Thorac Surg 2006;82:1876-1879
© 2006 The Society of Thoracic Surgeons

New Technology

Epicardial Beating Heart "Off-Pump" Ablation of Atrial Fibrillation in Non-Mitral Valve Patients Using New Irrigated Bipolar Radiofrequency Technology

Piotr Suwalski, MDa, Grzegorz Suwalski, MDa, Nicolas Doll, MD, PhDb,*, Franciszek Majstrak, MDa, Andrzej Kurowski, MDa, Kazimierz B. Suwalski, MD, PhDa

a Cardiac Surgery Department, Warsaw Medical University, Warsaw, Poland
b Department of Cardiac Surgery, Heart Center, University of Leipzig, Leipzig, Germany

Accepted for publication March 7, 2006.

* Address correspondence to Dr Doll, Heart Center Leipzig, Department of Cardiac Surgery, University of Leipzig, Strümpellstrasse 39, Leipzig, 04289 Germany. (Email: dolln{at}medizin.uni-leipzig.de).

PURPOSE: We evaluated the use of a novel irrigated bipolar radiofrequency system for the treatment of nonmitral paroxysmal atrial fibrillation.

DESCRIPTION: Between December 2003 and July 2005, 24 patients with paroxysmal atrial fibrillation underwent nonmitral cardiac procedures (coronary artery bypass grafting, n = 14; aortic valve replacement, n = 6; aortic valve replacement and coronary artery bypass grafting, n = 3; Bentall procedure, n = 1). In 12 of 14 of the coronary artery bypass graft patients, the procedure was performed off pump. All patients additionally underwent pulmonary vein isolation using the Medtronic Cardioblate BP system (Medtronic, Minneapolis, MN). Acute conduction block was evaluated in 16 patients.

EVALUATION: Patients were followed-up for 6 months. Major adverse events include 1 patient death and 1 patient requiring implantation of a pacemaker. At discharge 19 of 22 patients (86.3%) were in stable sinus rhythm. After 3 months, stable sinus rhythm was found in 15 of 21 patients (71%). After 6 months, 15 of 15 patients (100%) were in stable sinus rhythm. Complete conduction block was accomplished in 29 of 32 pulmonary vein pairs (91%) after a single radiofrequency ablation and in 31 of 32 pairs (97%) after a second application.

CONCLUSIONS: Pulmonary vein isolation with the use of this irrigated bipolar radiofrequency device is feasible, safe, and gains high experimental and clinical efficacy, including use during off-pump surgery.




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 Ann. Thorac. Surg.Home page
W. Wisser, G. Seebacher, T. Fleck, C. Aigner, C. Khazen, G. Stix, D. Hutschala, and E. Wolner
Permanent Chronic Atrial Fibrillation: Is Pulmonary Vein Isolation Alone Enough?
Ann. Thorac. Surg., October 1, 2007; 84(4): 1151 - 1157.
[Abstract] [Full Text] [PDF]


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