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Ann Thorac Surg 2002;74:2168
© 2002 The Society of Thoracic Surgeons

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New technology

Invited commentary

^a Departments of Surgery and Physiology, LSU Health Sciences Center, New Orleans, 1542 Tulane Avenue, 7th Floor, New Orleans, LA 70112-2822, USA

e-mail: tbruceferg732{at}pol.net

It is fitting that the first paper in the New Technology section of The Annals is related to surgical ablation of atrial fibrillation (AF), for several reasons. First, as indicated by Drs Gillinov and McCarthy, the field is now wide open with multiple energy sources, methods for application of those energy sources, and extreme variability of the lesion sets being utilized. Second, the New Technology section will permit the rapid accumulation of a wide variety of experience with multiple different technologies addressing AF ablation. Third, the coalescence of this information into the "optimal" approach for ablation of AF can be realized much more quickly with this method of information dissemination.

This clinical experience with the atricure bipolar radiofrequency device clearly documents the safety of this technology; no major complications or adverse events were reported as a result of its use. In addition, the feasibility of this technology to create lesions of conduction block is suggested by the large number of patients in this experience, and by the small (n = 10) subset in whom measurements were made. However, the efficacy of this technology cannot be established from this report due to the variety of preoperative arrhythmias, the variety of lesions sets, and the lack of reported results.

As surgeons are engaged by industry to evaluate new technology, it is critical that the collection of outcomes information be built into the evaluation process. Both adverse events (negative outcomes) as well as data to support efficacy (positive outcomes) will be of enormous value in the surgical community’s opportunity to objectively evaluate these New Technology reports.

This nice report is representative of an increasing interest in surgical AF ablation that will hopefully reenergize the cardiac surgical community in the entire field of arrhythmia ablation and control, including novel surgical approaches for device therapy. With the MADIT II and congestive heart failure candidate populations becoming more defined, there is a real opportunity to develop new, more efficacious ways to implant these technologies. Publication of these advances in this New Technology forum can be instrumental in this surgical electrophysiologic reemergence.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ferguson, T. B. Search for Related Content PubMed Articles by Ferguson, T. B., Jr Related Collections Electrophysiology - arrhythmias