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Ann Thorac Surg 2006;82:2264
© 2006 The Society of Thoracic Surgeons

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New Technology

Invited commentary

CT Surgery, UMass, 4802 Tenth Ave, Brooklyn, NY 11219

(Email: adam.saltman{at}umassmed.edu).

Williams and colleagues [1] describe their preclinical experience with a new energy source for the ablation of atrial tissue: the 980-nm laser. Because it was used through a thoracotomy and can be wrapped around the pulmonary veins as a flexible fiber, it potentially provides surgeons with another tool to accompany microwave and ultrasound as we progress toward perfecting a minimally invasive approach for the surgical treatment of atrial fibrillation. But more importantly than introducing an exciting new energy source, they have set the mark for an evaluative method whereby new technologies should be tested.

As this and even newer ablative energy sources have and will become available, it has become even more important for the surgeon to demand preclinical data before application in patients. We must not put the cart before the horse!

All energy sources in use today (except for unipolar cryothermy) are approved through the 510k process only for "tissue ablation"; none yet possesses labeling for the treatment of atrial fibrillation. Granted, achieving the latter will require significant effort on the part of device manufacturers and may not come for some time; however, we can and should investigate the available energy sources in preclinical models to create a database for comparison. We do not want to find ourselves in the same predicament as the catheter-based energy sources, where complications such as pulmonary vein stenosis and atrioesophageal fistula have been encountered far too frequently as a result of somewhat premature clinical application.

Williams and colleagues are to be commended for conducting an excellent study of the physiologic, pathologic, and histologic properties of this new ablation technology in a relevant animal model. They have given us a yardstick with which we should measure and compare our tools as this field continues to develop rapidly.

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1. Williams MR, Casher JM, Russo MJ, Hong KN, Argenziano M, Oz M. Laser energy source in surgical atrial fibrillation ablation: preclinical experience Ann Thorac Surg 2006;82:2260-2264.[Abstract/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 Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Adam E. Saltman Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Saltman, A. E. Search for Related Content PubMed PubMed Citation Articles by Saltman, A. E. Related Collections Electrophysiology - arrhythmias Related Article