Complete left atrial ablation with bipolar radiofrequency☆☆☆

Abstract

Performing the mitral line with bipolar radiofrequency is safe and cost-effective. A complete left atrial ablation with a single bipolar radiofrequency device yields excellent clinical mid-term results.

Prospective randomized comparison of left atrial and biatrial radiofrequency ablation in the treatment of atrial fibrillation

“…Recently, Benussi et al demonstrated a complete left atrial ablation with a single bipolar radiofrequency device yielding excellent clinical mid-term results. Freedom from AF was 84% at 6 months and 81% at 1 year [10]. In our study, the overall sinus restoration rate of 85.0% at about 4 years of follow-up, was acceptable in comparison to those of the previous series.…”

Mitral valve surgery plus concomitant atrial fibrillation ablation is superior to mitral valve surgery alone with an intensive rhythm control strategy☆☆☆

“…It is difficult to ensure a confluent ablation line between the left pulmonary veins and the mitral valve annulus and the tricuspid valve annulus with the bipolar device alone without potentially injuring coronary arteries, and we felt it advisable to use the monopolar pen for these lines for subsequent procedures. Alternative techniques to obtain transmurality to the mitral annulus with only the bipolar device have though been described [22]. In addition, total ablation time between the first 9 and last 18 enrolled patients in the Cardioblate group (success and failure combined) was significantly different with a longer ablation time for the later group (4:03 AE 1:07 vs 5:03 AE 1:12, p = 0.049).…”

“…Interestingly, only 1 patient in the Cardioblate group and 3 patients in the control group were using amiodarone at that time. At discharge, 22 Cardioblate patients (92%) and 13 control patients (52%, p = 0.004 vs Cardioblate group) were prescribed amiodarone. Over time, amiodarone use decreased to 7 patients (29%) in the Cardioblate group and 5 patients (22%) in the control group (CATMOD: group NS, time: p < 0.001, group  time: p = 0.003).…”

Impact of Lesion Sets on Mid-Term Results of Surgical Ablation Procedure for Atrial Fibrillation

“…In 2008, Benussi et al (13) demonstrated the safety and efficacy of a complete bipolar radiofrequency ablation, with superior results compared with those of the unipolar devices. Accordingly, we report here a significant improvement of electrophysiologi- Kaplan-Meier Curves for Combined Event-Free Survival, According to 5 Different Surgical Treatment Arms cal results during the follow-up by simple switching from unipolar to bipolar LA ablation.…”