The electrophysiologic basis for lesions of the contemporary Maze operation

Catheter ablation of atrial arrhythmias in patients after thoracoscopic ablation of persistent atrial fibrillation

“…Методика "разрез-шов" ("cut-and-sew"), лежащая в основе первоначальной процедуры "Лабиринт", обеспечивала хороший эффект и длительную свободу от ФП, но травматичность хирургических подходов, связанных с операцией, ограничивала ее применение в изолированном виде. В последующем, методика подвергалась значительным модификациям, в основном за счет использования альтернативных источников энергии [8]. Однако в ряде случаев, несмотря на эффективность метода, в послеоперационном периоде могут иметь место предсердные тахикардии, требующие для устранения детального высокоплотного картирования предсердий [9][10][11][12].…”

Robotic assisted cryothermic biatrial Cox‐Maze

“…This line is at the exact level as the ablation of the coronary sinus, covering the previously placed mark (Figure 7). Failure to transmurally ablate both the coronary sinus lesion and the corresponding mitral isthmus lesion can result in difficult‐to‐treat perimitral atrial flutter in 10%–15% of patients 4‐6 (Video ).…”

“…Fortunately, the electrophysiologic principles of the CM‐III biatrial lesions can be identically replicated with alternate power sources consisting of bipolar radiofrequency and/or cryothermia, the so called CM‐IV procedure (Figure 1). 4,5 These power sources have the ability to reliably produce linear, transmural lesions that interrupt the propagation of atrial triggers and reentrant circuits as effectively as the mechanical disruption of the CM‐III. Only surgical cryothermic probes have the ability to consistently construct all the lesions of the CM‐IV as a sole power source 4 …”

Left atrial appendage obliteration: Quo vadis?

“…4 Surgical LAA obliteration as a concomitant component of a Cox maze operation may be less controversial because of both its negative electrophysiologic impact and the potential ability to manage patients in sinus rhythm without anticoagulation. 5,6 For patients with AF not undergoing surgical ablation, the indications and efficacy of surgical LAA obliteration are less clear. Although signals of potential benefit are present from clinical registries, 7 randomized investigation has proved difficult.…”