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Ann Thorac Surg 2003;76:1715
© 2003 The Society of Thoracic Surgeons

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New technology

Invited commentary

^a Department of Surgery, LSU School of Medicine, 1542 Tulane Ave, 7th Floor, New Orleans, LA 70112, USA

e-mail: tbruceferg732{at}pol.net

In the reading of New Technology articles for The Annals, the reader must evaluate whether (1) the new technology is safe; (2) the new technology is efficacious, by itself and ideally compared to other similar technologies; (3) the patient population described is clinically representative; and (4) the new technology experience is accurately described in an unbiased manner.

This paper by Doll et al [1] is an early clinical experience of a new energy source for atrial fibrillation ablation using a commercially argon cryo catheter. The authors report on a small, moderately successful initial experience; it should not be overlooked that a majority of these patients were operated upon using a minithoracotomy approach. However, the diverse patient population and array of concomitant operative procedures lessens the ability to evaluate the technology per se, and the clinical efficacy is complicated by the high incidence of postoperative pacemaker requirements and the prolonged hospitalization for postsurgical atrial fibrillation treatment. Finally, the technology seems safe but in an earlier version of the manuscript there was a relatively high postoperative stroke rate in a smaller subset presented.

It should be emphasized, however, that candid presentation of early clinical experiences with new surgical technologies is precisely the purpose of this section of The Annals. Clearly more clinical experience with this and essentially all technologies [2] being evaluated for use in less invasive methods for atrial fibrillation ablation is necessary. There will be no "magic bullet" in these technical advancements, but rather the progressive evolution of information that leads to a consensus surgical approach using perhaps two ablative technologies deemed superior. These New Technology reports can facilitate this process.

References

1. Doll N, Kiaii B, Bucerius J, et al. Intraoperative left atrial ablation (for atrial fibrillation) using a new Argon cryocatheter: Early clinical experience. Ann Thorac Surg 2003;76:1711–5
2. Damiano R.J. Alternative energy sources for atrial ablation: Judging the new technology. Ann Thorac Surg 2003;75:329-330.[Free Full Text]

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