Details

Autor(en) / Beteiligte

• Ninet, Jean
• Roques, Xavier
• Seitelberger, Rainald
• Deville, Claude
• Pomar, Jose Luis
• Robin, Jacques
• Jegaden, Olivier
• Wellens, Francis
• Wolner, Ernst
• Vedrinne, Catherine
• Gottardi, Roman
• Orrit, Javier
• Billes, Marc-Alain
• Hoffmann, Drew A.
• Cox, James L.
• Champsaur, Gerard L.

Titel

Surgical ablation of atrial fibrillation with off-pump, epicardial, high-intensity focused ultrasound: Results of a multicenter trial

Ist Teil von

• The Journal of thoracic and cardiovascular surgery, 2005-09, Vol.130 (3), p.803.e1-803.e8

Ort / Verlag

Philadelphia, PA: Mosby, Inc

Erscheinungsjahr

2005

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• A simplified alternative to the Cox maze procedure to treat atrial fibrillation with epicardial high-intensity focused ultrasound was evaluated clinically, and the initial clinical results were assessed at the 6-month follow-up visit. From September 2002 through February 2004, 103 patients were prospectively enrolled in a multicenter study. Atrial fibrillation duration ranged from 6 to 240 months (mean, 44 months) and was permanent in 76 (74%) patients, paroxysmal in 22 (21%) patients, and persistent in 5 (5%) patients. All patients had concomitant operations, and ablation was performed epicardially on the beating heart before the concomitant procedure. The device automatically created a circumferential left atrial ablation around the pulmonary veins in an average of 10 minutes, and an additional mitral line was created epicardially in 35 (34%) patients with a handheld device by using the same technology. No complications or deaths were device or procedure related. There were 4 (3.8%) early deaths and 2 late extracardiac deaths. The 6-month follow-up was complete in all survivors. At the 6-month visit, freedom from atrial fibrillation was 85% in the entire study group (80% in patients with permanent atrial fibrillation, 88% in the 35 patients who had the additional mitral line, and 100% in patients with paroxysmal atrial fibrillation). A pacemaker was implanted in 8 patients. Only the duration and type of atrial fibrillation significantly increased the risk of recurrence. Epicardial, off-pump, beating-heart ablation with acoustic energy is safe and cures 80% of patients with permanent atrial fibrillation associated with long-standing structural heart disease.