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Ann Thorac Surg 1999;67:671
© 1999 The Society of Thoracic Surgeons

Commentary

T. Bruce Ferguson, Jr, MDa

a Departments of Surgery and Physiology, Louisiana State University Medical Center, 1542 Tulane Ave, 7th Floor, New Orleans, LA 70112-2822, USA

Invited commentary

From the vantage point of cardiothoracic surgery it seems that ablative therapy for cardiac arrhythmias is largely a thing of the past. Most antiarrhythmic devices are now implanted by cardiologists, and referrals of patients for ablative therapy of ventricular tachycardia, even when indicated, are seldom initiated. The maze procedure has been interpreted by the cardiology community as too complicated and risky an operation for patients with atrial fibrillation.

As such, the study by Watanabe and associates entitled "Experimental Application of Microwave Tissue Coagulation to Ventricular Myocardium" might seem beyond the scope of interest for publication in The Annals of Thoracic Surgery. However, this experimental study describes the first in vivo application of microwave energy to myocardial tissue, with clearly documented results. The lesions are safe and nonarrhythmogenic. The energy source is readily controllable, at least from an epicardial approach. These characteristics distinguish microwave energy controlled in this manner from other types of ablative techniques, including cryosurgery, laser ablation, and radiofrequency ablation.

These unique characteristics suggest that application of controlled energy, via a minimally invasive approach, might be developed for ventricular tachycardial ablation in nonaneurysmal heart disease. Even more exciting is the possibility of adapting this ablative energy technology to the epicardial, off-bypass ablation of atrial fibrillation, again via a minimally invasive approach.


Related Article

Experimental application of microwave tissue coagulation to ventricular myocardium
Hiroshi Watanabe, Jun-ichi Hayashi, Masaaki Sugawara, Masahide Hiratsuka, and Shoji Eguchi
Ann. Thorac. Surg. 1999 67: 666-671. [Abstract] [Full Text] [PDF]




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