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Ann Thorac Surg 2003;75:329-330
© 2003 The Society of Thoracic Surgeons

Editorial

Alternative energy sources for atrial ablation: judging the new technology

Ralph J. Damiano, Jr, MDa*

a Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, Missouri, USA

* Address reprint requests to Dr Damiano, Washington University School of Medicine, Division of Cardiothoracic Surgery, One Barnes-Jewish Hospital Plaza, Queeny Tower, Suite 3308, St. Louis, MO, USA
e-mail: damianor@msnotes.wustl.edu

The first 20% of the full text of this article appears below.

In 1987 Dr James Cox introduced a new operation for treating atrial fibrillation. The Maze procedure created several incisions throughout both the left and right atria. These incisions were designed to block the multiple macroreentrant circuits felt to be responsible for atrial fibrillation. Over the years Dr Cox and his group had developed a successful paradigm for introducing operations for cardiac arrhythmias. This paradigm was based on first developing a sound understanding of the fundamental substrates and interactive mechanisms. Successful surgical interventions were only introduced clinically after a thorough understanding of the basic electrophysiology and anatomy was developed in the laboratory in animal models [1].

After the clinical introduction of the Maze procedure it went through several iterations before settling on what has become the gold standard for treating atrial fibrillation, the Cox-Maze III procedure. Our long-term results at Washington University have revealed a cure rate of more than 96% at 10 years [2]. Despite its remarkable success the operation has not been widely adopted by surgeons, in part owing to its technical . . . [Full Text of this Article]




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