Successful Performance of Cox-Maze Procedure on Beating Heart Using Bipolar Radiofrequency Ablation: A Feasibility Study in Animals

Gaynor, Sydney L.; Ishii, Yôsuke; Diodato, Michael D.; Prasad, Sunil; Barnett, Kara M.; Damiano, Nicholas R.; Byrd, Gregory D.; Wickline, Samuel A.; Schuessler, Richard B.; Damiano, Ralph J.

doi:10.1016/j.athoracsur.2004.04.058

Cited by 81 publications

(69 citation statements)

References 24 publications

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“…The energy is confined to within the jaws of the clamp, reducing the possibility of collateral cardiac or extracardiac damage. By measuring the tissue conductance between the two electrodes, algorithms have been developed that help predict lesion transmurality in the experimental laboratory [677,680,681]. The weakness of these devices is that they can only ablate tissue that can be clamped within the jaws of the device.…”

Section: New Surgical Ablation Technologymentioning

confidence: 99%

“…However, these energy sources have a fixed depth of penetration, which may make their use in pathologically thickened atria problematic. Bipolar RF ablation has been able to overcome some of these shortcomings [677][678][679]. Since energy is delivered between two closely approximated electrodes embedded in the jaw of a clamp device, the energy is focused and results in discrete lesions.…”

Section: New Surgical Ablation Technologymentioning

confidence: 99%

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2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design

Calkins

Kuck

Cappato

et al. 2012

J Interv Card Electrophysiol

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1,468

680

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This is a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation, developed in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology and the European Cardiac Arrhythmia Society (ECAS), and in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society of Thoracic Surgeons (STS). This is endorsed by the governing bodies of the ACC Foundation, the AHA, the ECAS, the EHRA, the STS, the APHRS, and the HRS.

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Section: New Surgical Ablation Technologymentioning

confidence: 99%

Section: New Surgical Ablation Technologymentioning

confidence: 99%

2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design

Calkins

Kuck

Cappato

et al. 2012

J Interv Card Electrophysiol

Self Cite

1,468

680

View full text Add to dashboard Cite

show abstract

“…However, although the bipolar RF ablation device allows the surgeon to isolate targeted tissue and create transmural lesions, [14][15][16][17] it is not absolutely perfect because all the lesions produced a clinical conduction block. 18 Indeed, one study showed that gaps smaller than 1 mm can allow propagation of AF.…”

Section: Discussionmentioning

confidence: 98%

“…13 Moreover, many experimental studies have indicated that bipolar RF ablation results in the most consistent transmural lesions. [14][15][16][17] In a failing Fontan case with a very thick atrial wall, the creation of a transmural lesion is critical for successfully treating the chronic AT.…”

Section: Discussionmentioning

confidence: 99%

Fontan conversion with novel direct ablation after childbirth: Report of a case

et al. 2011

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A 38-year-old woman underwent atriopulmonary Fontan surgery at age 18 years and subsequently successfully delivered a girl by cesarean section at age 34. Her condition later deteriorated due to atrial tachyarrhythmia and progressed to New York Heart Association (NYHA) class IV heart failure. Her treatment, at age 36, comprised total cavopulmonary connection conversion, direct right atrial ablation with bipolar radiofrequency devices, the creation of an atrial septal defect, and placement of a dual-chamber permanent pacemaker. Three years after the conversion, her condition has improved to NYHA class I.

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“…Development of technologies to create scars without cutting of tissue brought renewed interest in the Maze procedure. This led to simplification of the Cox-Maze III to the Cox-Maze IV technique (100,101). This method utilizes new ablation technologies to replace the "cut-and-sew" technique (101) and utilize heating or freezing to create scars while leaving the structure intact.…”

Section: Cox-maze IVmentioning

confidence: 99%

Atrial fibrillation: review of current treatment strategies

Xu¹,

Luc²,

Phan³

2016

J. Thorac. Dis.

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Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in modern clinical practice, with an estimated prevalence of 1.5-2%. The prevalence of AF is expected to double in the next decades, progressing with age and increasingly becoming a global medical challenge. The first-line treatment for AF is often medical treatment with either rate control or anti-arrhythmic agents for rhythm control, in addition to anti-coagulants such as warfarin for stroke prevention in patient at risk. Catheter ablation has emerged as an alternative for AF treatment, which involves myocardial tissue lesions to disrupt the underlying triggers and substrates for AF. Surgical approaches have also been developed for treatment of AF, particularly for patients requiring concomitant cardiac surgery or those refractory to medical and catheter ablation treatments. Since the introduction of the Cox-Maze III, this procedure has evolved into several modern variations, including the use of alternative energy sources (Cox-Maze IV) such as radiofrequency, cryo-energy and microwave, as well as minimally invasive thoracoscopic epicardial approaches. Another recently introduced technique is the hybrid ablation approach, where in a single setting both epicardial thoracoscopic ablation lesions and endocardial catheter ablation lesions are performed by the cardiothoracic surgeon and cardiologist. There remains controversy surrounding the optimal approach for AF ablation, energy sources, and lesion sets employed. The goal of this article is review the history, classifications, pathophysiology and current treatment options for AF.

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Successful Performance of Cox-Maze Procedure on Beating Heart Using Bipolar Radiofrequency Ablation: A Feasibility Study in Animals

Cited by 81 publications

References 24 publications

2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design

2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design

Fontan conversion with novel direct ablation after childbirth: Report of a case

Atrial fibrillation: review of current treatment strategies

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