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): Mark A. Groh Oliver A. Binns Harry G. Burton, III Stephen W. Ely Alan M. Johnson Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Groh, M. A. Articles by Johnson, A. M. Search for Related Content PubMed PubMed Citation Articles by Groh, M. A. Articles by Johnson, A. M. Related Collections Electrophysiology - arrhythmias

---

Original Articles: Cardiovascular

Ultrasonic Cardiac Ablation for Atrial Fibrillation During Concomitant Cardiac Surgery: Long-Term Clinical Outcomes

Mission Saint Joseph Hospital, Asheville, North Carolina

Accepted for publication June 27, 2007.

^_* Address correspondence to Dr Groh, Asheville Cardiovascular and Thoracic Surgeons PA, 257 McDowell St, Asheville, NC 28803 (Email: mgroh{at}avlcvsurgeons.com).

Background: Therapeutic ultrasound as an alternative to the maze procedure was evaluated in this large US experience. Safety and efficacy were assessed at 6-, 12-, and 18-month visits with systematic 24-hour Holter monitoring.

Methods: From February 2005 to February 2007, 220 patients were prospectively enrolled in a single center study, and among them 129 patients with concomitant cardiac surgery and at least 6-month follow-up were reviewed. Primary procedures were mitral surgery in 50% of the cases, coronary bypass in 32%, and aortic surgery in 16%. Atrial fibrillation was permanent in 66 (51.1%), paroxysmal in 43 (33.3%), and persistent in 20 (15.5%) patients. An epicardial and circumferential left atrial encircling line was created on the beating heart. Routinely a mitral isthmus line was also created from the left atrium epicardium using an ultrasonic handheld device.

Results: No morbidity or mortality was device-related. There were four (2.33%) early deaths and six late extra-cardiac deaths. Follow-up ranged from 6 to 670 days with a mean follow-up of 358.5 days, median 340 days with two patients lost to follow-up. Freedom from atrial fibrillation or left-sided flutter was 83.2%, 84.4%, and 86.2% at 6, 12, and 18 months, respectively. A pacemaker was implanted in seven patients (5.4%). Male gender and left atrial dimension were significant risk factors for failure.

Conclusions: The study confirms the excellent safety record of the technology, and the efficacy at the level reported in a previous European multicenter study. Efficacy is also maintained at longer (12 and 18 months) follow-up.

This article has been cited by other articles:

				M. Groh Off-pump epicardial high intensity focused ultrasound ablation of atrial fibrillation in patients undergoing structural heart repair MMCTS, June 18, 2009; 2009(0618): 3061. [Abstract] [Full Text] [PDF]

				J. S. Gammie, P. Didolkar, L. S. Krowsoski, M. J. Santos, A. J. Toran, C. A. Young, B. P. Griffith, S. R. Shorofsky, and T. J. Vander Salm Intermediate-term outcomes of surgical atrial fibrillation correction with the CryoMaze procedure. Ann. Thorac. Surg., May 1, 2009; 87(5): 1452 - 1458. [Abstract] [Full Text] [PDF]