Treatment of atrial fibrillation by creating linear lesions in patients undergoing heart surgery (mitral valve replacement or coronary bypass grafting) receives increasing interest. Conventional rhythm surgery require tremendous operative effort and increases the risks of perioperative complications. For that reason various alternative methods for creating linear lesion are under investigation. This paper discusses several techniques for creation of transmural lesions in open heart surgery, e.g. ultra sound ablation, high current DC shocks, laser ablation, cryoablation, radio frequency ablation, cooled radio frequency ablation, and microwave ablation.

Concomitant microwave ablation for curative treatment of atrial fibrillation (AF) was performed in 18 patients with history of chronic atrial fibrillation and indication for open heart surgery, 11 patients with mitral valve replacement and 7 patients with coronary artery bypass grafting. There were no perioperative complications. During the postoperative period most of the patients had intermittent AF, they received low dose Sotalol therapy and electric cardioversions. Up to now seven patients have reached follow-up day 90. One patient has persistent AF. Two patients had typical atrial flutter that was electrically converted to sinus rhythm (SR), isthmus ablation is planned. The other four patients have SR, one patient without cardioversions. These four patients show recovered atrial function with observed A-wave for transmitral flow. Under visual guidance the continuous atrial lesion lines could be induced effectively and safely by the intraoperative device Lynx.

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