Surgical Epicardial Ablation on Beating Heart for Lone Atrial Fibrillation: Early Results

BAC K G R O U N D Atr ial fibrillation (AF) is the most common arrhyt h m ia with a prev al e nce of 0.5-1%. The inc id e nce can rise up to 10% with age. There has been an inc r e asing interest in act ive trea tment strat eg ies such as Maze proc ed ures and percut an e ous abl at ion proc ed ures in trea tment of AF. In the recent years, alt e rn at ive techn iq ues of rad io frequency, l aser, ult r as ound and micr ow ave have been developed. Microwave abl at ion for AF has been proven to be effective in trea tment of AF ass ociated with other card iac pathol og ies such as valv ular and isch a emic heart dis e ase. We p r esent our early exp er ie nce with epic a rd ial micr ow av e abl at ion on beating heart for trea tment of isol ated AF. M ET H O D S Micr ow ave epic a rd ial abl at ion was perf o rmed in four cons ec ut ive isol ated AF pat ients in our hosp ital betw ee n September 2002 and Nov e mber 2003. All of the patients had previous uns u cc e s sful attempts of multiple card io v e rs ions and perc ut an e ous end oc a rd ial AF abl at ion with m a pping. Epic a rd ial micr ow ave abl at ion was perf o rmed using a micr ow ave probe set at 75 watts appl ied for 90 s econds to create a les ion pattern termed as ‘box lesion’. R E S U LTS The follow-up has ranged between 2 and 17 months (mean 6.7 months). Three of patients have remained in sinus rhythm at all times and an echocardiogram has confirmed that atrial contractility and its other mechanic functions were good in these patients. CO N C L U S I O N S We acknowledge that this is a small case series with a short follow-up but we have found this early experience encouraging. This approach potentially offers a surgical ablation strategy for patients with isolated AF with minimal operative risks. Key words: Atrial fibrillation; ablation; surgical ablation.