The Heart Surgery Forum, Volume 7, Issue 6

Bipolar Irrigated Radiofrequency Ablation of the Posterior- Inferior Left Atrium and Coronary Sinus is Feasible and Safe

Calin Vicol,¹ Felix Kur,¹ Sandra Eifert,¹ Martin Oberhoffer,¹ Georg Nollert,¹ Bernd Wintersperger,² Bruno Reichart¹

Departments of ¹Cardiac Surgery and ²Radiology, Grosshadern Medical Center, Ludwig-Maximilians- University Munich, Munich, Germany

ABSTRACT

Background: Success of surgical therapy for atrial fibrillation (AF) mainly depends on creating a complete set of transmural atrial lesions. The established Cox procedures may be simplified by dropping lesions, but not without the risk of impaired results. We aimed to create a complete set of lesions using bipolar irrigated radiofrequency including ablation of the posterior-inferior left atrium (LA) and coronary sinus. Feasibility and safety were investigated.

Methods: Six patients (mean age 63 ± 14 years) with continuous AF (duration 15 ± 8 months) underwent elective heart surgery for isolated mitral valve procedures (n = 4), in combination with myocardial revascularization (n = 1) or isolated bypass surgery (n = 1). Ablation of AF was performed using bipolar irrigated radiofrequency to create a modified Cox minimaze pattern.

Results: No major intraoperative or postoperative complication occurred. Two patients left the operating room in sinus rhythm and 4 in junctional rhythm with atrioventricular pacing. AF ablation required 20 ± 5 minutes.

Conclusions: Bipolar irrigated radiofrequency ablation including ablation of the posterior-inferior LA and coronary sinus is feasible and can be performed safety. Long-term studies in large patient cohorts are necessary to show efficiency of this method.

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