Electrophysiologic efficacy of irrigated bipolar radiofrequency in the clinical setting

Benussi, Stefano; Galanti, Andrea; Zerbi, Valerio; Privitera, Ylenia Adelaide; Iafelice, Ida; Alfieri, Ottavio

doi:10.1016/j.jtcvs.2009.12.039

Cited by 32 publications

(14 citation statements)

References 22 publications

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“…Finally, even if our results with RF does not match the animal experimental results (99% of the lesions were transmural in pig heart [26] and 92% of the lesions were transmural in ovine heart [16]), they seem to corroborate the human electrophysiological results of Benussi [27]. He advises to repeat the procedure 3 times around the pulmonary veins before getting a block, witness of transmurality.…”

Section: Discussioncontrasting

confidence: 55%

Human comparative experimental study of surgical treatment of atrial fibrillation by epicardial techniques

Arid

Sénage

Toquet³

et al. 2013

J Cardiothorac Surg

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BackgroundTo set up an experimental model of cadaveric heart in order to evaluate and compare histologic transmurality of lesions immediately caused by different energy sources of anti-arrhythmic epicardial devices.MethodsProcedures were performed on a cadaveric human heart in orthotopic position with an ischemic time of 48 h at 37° and supported through the use of cardiopulmonary bypass. Three anti-arrhythmic epicardial devices were studied: the bipolar forceps Cardioblate BP (Medtronic) for the radiofrequency, the Epicor Ultracinch LP Ablation device (St. Jude) for ultrasound and the Cardioblate CryoFlex (Medtronic) device for cryoablation. Histological features of lesions made at the pulmonary venous confluence assessed the effectiveness of different energy sources.ResultsOver 45 experimentations performed, only 28 were considered correct and retained for histological analysis. Three distinct groups were studied according to the type of procedure performed: group 1 (Radiofrequency, n = 12), group 2 (ultrasound, n = 4), group 3 (cryoablation, n = 10) and controls (n = 2). All analysed samples showed histological changes with a success rates of transmurality of 33% for radiofrequency, 25% for ultrasound and 90% for cryotherapy (p <0.001). The average length of transmurality, when it was reached and the proportion of transmurality over the total length of the lesion were respectively 12 ± 6 mm and 37 ± 18% for group 1, 10 mm and 33% for group 2 and 11.1 ± 1.1 mm and 35 ± 5% for group 3.ConclusionImmediate detectable histological transmural lesions after epicardial procedure are discontinuous whatever the kind of energy source tested in this work and it strongly encourages the repetition of radiofrequency procedures. Nevertheless, our experimental model seems inadequate to assess ultrasound energy efficacy.

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Section: Discussioncontrasting

confidence: 55%

Human comparative experimental study of surgical treatment of atrial fibrillation by epicardial techniques

Arid

Sénage

Toquet³

et al. 2013

J Cardiothorac Surg

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“…To our knowledge, the majority of studies regarding concomitant AF ablation during surgery estimated the efficacy of ablation through 24-or 48-h Holter monitoring [17,20,21]. Although such methods are recommended to be used in current consensus for AF management, there may be an increase of asymptomatic events after AF ablation [6,22], which could potentially increase the risk of stroke due to undetected, silent AF.…”

Section: Discussionmentioning

confidence: 99%

Ablation of paroxysmal atrial fibrillation during coronary artery bypass grafting: 12 months’ follow-up through implantable loop recorder

Pokushalov

Romanov

Cherniavsky

et al. 2011

European Journal of Cardio-Thoracic Surgery

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“…Повышение эффективности хирургического лечения ФП является важным фактором профилактики сердеч-ной недостаточности в послеоперационном периоде [25,26,27,39,49,50,55,57].…”

Section: особенности хирургического лечения длительно персистирующей unclassified

Rules and Principles of Patient Selection for Surgical Treatment of Acquired Heart Diseases Complicated by Atrial Fibrillation

Евтушенко¹,

Makogonchuk²,

Евтушенко³

2017

Sib. med. ž. (Tomsk)

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Научно-исследовательский институт кардиологии, Томский национальный исследовательский медицинский центр Российской академии наук, Томск, Российская Федерация Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation В данной статье приводится обзор современных рекомендаций и принципов отбора пациентов с приобретен-ной патологией сердца, осложненной фибрилляцией предсердий (ФП), на хирургическое лечение. Проведен ана-лиз эффективности различных способов лечения ФП у таких пациентов, а также современных критериев отбора данной категории больных на операцию. Так, медикаментозное лечение пациентов с ФП малоэффективно, а при наличии пороков сердца и ишемической болезни сердца (ИБС), требующих хирургической коррекции, еще и не-целесообразно. Предпочтение в данном случае следует отдать хирургическому лечению основной патологии с од-номоментной хирургической коррекцией ФП. Показано, что при выборе тактики вмешательства важно учитывать не только наличие самой патологии, но и исходное функциональное состояние элементов проводящей системы сердца. Так, наличие у пациентов с длительно персистирующей ФП исходной дисфункции синусового узла (ДСУ) статистически значимо увеличивает вероятность имплантации пациенту искусственного водителя ритма и про-лонгирует его нахождение в палате интенсивной терапии. The present article provides an overview of the latest guidelines and the principles of selecting the patients with acquired heart diseases complicated by atrial fibrillation (AF) for surgical treatment. The effectiveness of various methods of AF treatment in such patients is analyzed. The criteria for selecting patients of this group for an operation are described. The use of antiarrhythmic drugs in patients with AF is ineffective and even inappropriate in cases of valvular heart disease and coronary artery disease requiring surgical correction. Surgical treatment of the main heart pathology and concomitant AF ablation in these patients is preferable. When choosing tactics of intervention, it is necessary to consider not only the presence of the pathology itself, but also the baseline functional state of the elements of cardiac conduction system. The presence of initial sinus node dysfunction in patients with long-lasting persistent AF significantly increases the probability of pacemaker implantation and prolongs a patient's stay in the intensive care unit. Keywords: long-lasting persistent atrial fibrillation, radiofrequency maze procedure, sinus node dysfunction Conflict of interest: the authors did not declare a conflict of interest For citation: Evtushenko

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Electrophysiologic efficacy of irrigated bipolar radiofrequency in the clinical setting

Cited by 32 publications

References 22 publications

Human comparative experimental study of surgical treatment of atrial fibrillation by epicardial techniques

Human comparative experimental study of surgical treatment of atrial fibrillation by epicardial techniques

Ablation of paroxysmal atrial fibrillation during coronary artery bypass grafting: 12 months’ follow-up through implantable loop recorder

Rules and Principles of Patient Selection for Surgical Treatment of Acquired Heart Diseases Complicated by Atrial Fibrillation

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