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Initial Clinical Experience with a New Microwave Ablation
Catheter for Thoracoscopic Use in Atrial Fibrillation Treatment
Bas Mochtar1, Jos G. Maessen2
1Department of Cardiothoracic Surgery, University of Maastricht,
Maastricht, Netherlands,
2Cardiovascular Research Institute
Maastricht, Maastricht, Netherlands
OBJECTIVE: Recently, we demonstrated the efficacy of epicardial,
offpump ablation for atrial fibrillation with a 4 cm microwave
antenna. The Flex-10 (AFx-inc, Fremont, CA) is a novel device
with a 20 cm flexible microwave catheter allowing thoracoscopic
use.
METHODS: In various animal species (goat, sheep, dog, and pig,N =
6) the ability to produce with this catheter, a single
contiguous, transmural lesion line completely encircling the
pulmonary veins, was tested.To evaluate its clinical feasibility,
after getting a CE mark in January 2002, 3 patients were treated
with the new device (February 2002).
RESULTS: Using the full length of the catheter, with
video-assistance and thoracoscopic instruments, complete,
electrical isolation of the pulmonary veins was achieved with a
single application. In all but one animals, transmural lesions
were obtained. Whereas the animals were approached from the left
thoracic side, the patients were approached from the right side
to facilitate opening of the pericardial reflections between
caval veins and pulmonary veins. The catheter lenght allowed
complete encircling of the pulmonary veins. Isolation was
effective as evidenced by electrophysiologic examination. The
left atrial appendage was removed with an endoscopic stapling
device. No complications occurred.
CONCLUSIONS: The Flex-10 microwave catheter simplifies epicardial
ablation for atrial fibrillation on the offpump beating heart and
allows a thoracoscopic approach.
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