Off-Pump Epicardial Atrial Fibrillation Surgery Utilizing a Novel Bipolar Radiofrequency System

Authors

  • Deon W. Vigilance
  • Mauricio Garrido
  • Mathew Williams
  • Elaine Wan
  • Ann Zeidner
  • Jennifer Casher
  • Aftab Kherani
  • Jeffrey Morgan
  • Yoshifumi Naka
  • Craig Smith
  • Mehmet C. Oz
  • Michael Argenziano

DOI:

https://doi.org/10.1532/HSF98.20061019

Abstract

Background. Over the past several years, pulmonary vein isolation for the treatment of atrial fibrillation has gained significant popularity. This study was undertaken to evaluate a novel radiofrequency (RF)-enabled clamp system designed to create transmural lesions epicardially on the beating heart using bipolar RF.

Methods. A set of differently shaped clamps modified to deliver bipolar RF energy were used to create a series of lesions in a beating heart canine model. The pulmonary veins and atrial appendages of 6 dogs were electrically isolated using bipolar RF energy. The right and left atrial appendages served as controls for the right and left pulmonary veins, respectively. Temperature-controlled RF energy was delivered to maintain a tissue temperature of 80°C for 15 seconds. Electrical isolation was assessed acutely and after 4 weeks by a bipolar pacing protocol.

Results. A total of 24 circumferential lesions were created. By pacing analysis, 100% (24/24) of these lesions were electrically isolated acutely and 95% (19/20) were still isolated 4 weeks later. At 4 weeks, 92% (22/24) of lesions were transmural by histologic analysis, and 96% (23/24) demonstrated endocardial continuity. One animal experienced a fatal cardiac arrhythmia during initiation of the post-survival procedure, prior to electrophysiologic evaluation, accounting for the reduced number of potential electrically isolated lesions.

Conclusion. Bipolar RF ablation utilizing a novel bipolar RF clamp device results in electrical isolation and histologic transmurality in an off-pump epicardial model.

References

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Published

2006-08-07

How to Cite

Vigilance, D. W., Garrido, M., Williams, M., Wan, E., Zeidner, A., Casher, J., Kherani, A., Morgan, J., Naka, Y., Smith, C., Oz, M. C., & Argenziano, M. (2006). Off-Pump Epicardial Atrial Fibrillation Surgery Utilizing a Novel Bipolar Radiofrequency System. The Heart Surgery Forum, 9(5), E803-E806. https://doi.org/10.1532/HSF98.20061019

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