Open-heart endocardial radiofrequency ablation: An alternative to incisions in maze surgery

James A. Caccitolo, John M. Stulak, Hartzell V Schaff, David Francischelli, Donald N. Jensen, Rahul Mehra

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background. Radiofrequency (RF) ablation produces transmural atrial lesions in vitro, and may provide advantages over incisions currently used in maze surgery. This study examines the feasibility, safety, and efficacy of open-heart endocardial RF ablation. Methods. Eighteen sheep (42.8 ± 4.4 kg, age < 2 years) underwent left thoracotomy with placement of pacing leads on a pulmonary vein and the left atrial dome. On cardiopulmonary bypass, lesions were made using incision and suture or a novel RF ablation device in three sites: PVC = circle excluding pulmonary veins, IAB = line across the interatrial bundle, SVC = line from the superior to the inferior vena cava. Pacing across the PVC lesion was attempted to assess the completeness of each lesion. Preselected animals (incision n = 4, RF n = 5) were recovered and pacing attempts were repeated at 1 month. After sacrifice, hearts were sectioned and measured for lesion size and completeness. Results. RF ablation lesions took less time to create (total bypass time: RF 51.8 min vs incision 106 min, P < 0.001). No evidence of thromboembolism, atrial rupture, or coronary sinus thrombosis was seen. All PVC lesions were complete as demonstrated by the inability to pace across them. Stained sections demonstrated that acutely studied incision lesions were thinner than RF lesions; however, all lesions were transmural and similar in width at 1 month. Conclusions. RF ablation consistently created transmural lesions more quickly than the incision and suture method and without additional complications. Endocardial RF ablation appears to be a simple and effective alternative to surgical incisions during open-heart atrial Maze procedures.

Original languageEnglish (US)
Pages (from-to)27-33
Number of pages7
JournalJournal of Surgical Research
Volume97
Issue number1
DOIs
StatePublished - 2001

Fingerprint

Polyvinyl Chloride
Pulmonary Veins
Sutures
Intracranial Sinus Thrombosis
Coronary Thrombosis
Coronary Sinus
Thromboembolism
Inferior Vena Cava
Feasibility Studies
Thoracotomy
Cardiopulmonary Bypass
Rupture
Sheep
Safety
Equipment and Supplies

Keywords

  • Ablation
  • Animal
  • Arrhythmia
  • Atrial fibrillation
  • Endocardial
  • Maze
  • Radiofrequency
  • Sheep
  • Surgery

ASJC Scopus subject areas

  • Surgery

Cite this

Open-heart endocardial radiofrequency ablation : An alternative to incisions in maze surgery. / Caccitolo, James A.; Stulak, John M.; Schaff, Hartzell V; Francischelli, David; Jensen, Donald N.; Mehra, Rahul.

In: Journal of Surgical Research, Vol. 97, No. 1, 2001, p. 27-33.

Research output: Contribution to journalArticle

Caccitolo, James A. ; Stulak, John M. ; Schaff, Hartzell V ; Francischelli, David ; Jensen, Donald N. ; Mehra, Rahul. / Open-heart endocardial radiofrequency ablation : An alternative to incisions in maze surgery. In: Journal of Surgical Research. 2001 ; Vol. 97, No. 1. pp. 27-33.
@article{f6ec5d6f962246ea93587b94c3047d87,
title = "Open-heart endocardial radiofrequency ablation: An alternative to incisions in maze surgery",
abstract = "Background. Radiofrequency (RF) ablation produces transmural atrial lesions in vitro, and may provide advantages over incisions currently used in maze surgery. This study examines the feasibility, safety, and efficacy of open-heart endocardial RF ablation. Methods. Eighteen sheep (42.8 ± 4.4 kg, age < 2 years) underwent left thoracotomy with placement of pacing leads on a pulmonary vein and the left atrial dome. On cardiopulmonary bypass, lesions were made using incision and suture or a novel RF ablation device in three sites: PVC = circle excluding pulmonary veins, IAB = line across the interatrial bundle, SVC = line from the superior to the inferior vena cava. Pacing across the PVC lesion was attempted to assess the completeness of each lesion. Preselected animals (incision n = 4, RF n = 5) were recovered and pacing attempts were repeated at 1 month. After sacrifice, hearts were sectioned and measured for lesion size and completeness. Results. RF ablation lesions took less time to create (total bypass time: RF 51.8 min vs incision 106 min, P < 0.001). No evidence of thromboembolism, atrial rupture, or coronary sinus thrombosis was seen. All PVC lesions were complete as demonstrated by the inability to pace across them. Stained sections demonstrated that acutely studied incision lesions were thinner than RF lesions; however, all lesions were transmural and similar in width at 1 month. Conclusions. RF ablation consistently created transmural lesions more quickly than the incision and suture method and without additional complications. Endocardial RF ablation appears to be a simple and effective alternative to surgical incisions during open-heart atrial Maze procedures.",
keywords = "Ablation, Animal, Arrhythmia, Atrial fibrillation, Endocardial, Maze, Radiofrequency, Sheep, Surgery",
author = "Caccitolo, {James A.} and Stulak, {John M.} and Schaff, {Hartzell V} and David Francischelli and Jensen, {Donald N.} and Rahul Mehra",
year = "2001",
doi = "10.1006/jsre.2001.6094",
language = "English (US)",
volume = "97",
pages = "27--33",
journal = "Journal of Surgical Research",
issn = "0022-4804",
publisher = "Academic Press Inc.",
number = "1",

}

TY - JOUR

T1 - Open-heart endocardial radiofrequency ablation

T2 - An alternative to incisions in maze surgery

AU - Caccitolo, James A.

AU - Stulak, John M.

AU - Schaff, Hartzell V

AU - Francischelli, David

AU - Jensen, Donald N.

AU - Mehra, Rahul

PY - 2001

Y1 - 2001

N2 - Background. Radiofrequency (RF) ablation produces transmural atrial lesions in vitro, and may provide advantages over incisions currently used in maze surgery. This study examines the feasibility, safety, and efficacy of open-heart endocardial RF ablation. Methods. Eighteen sheep (42.8 ± 4.4 kg, age < 2 years) underwent left thoracotomy with placement of pacing leads on a pulmonary vein and the left atrial dome. On cardiopulmonary bypass, lesions were made using incision and suture or a novel RF ablation device in three sites: PVC = circle excluding pulmonary veins, IAB = line across the interatrial bundle, SVC = line from the superior to the inferior vena cava. Pacing across the PVC lesion was attempted to assess the completeness of each lesion. Preselected animals (incision n = 4, RF n = 5) were recovered and pacing attempts were repeated at 1 month. After sacrifice, hearts were sectioned and measured for lesion size and completeness. Results. RF ablation lesions took less time to create (total bypass time: RF 51.8 min vs incision 106 min, P < 0.001). No evidence of thromboembolism, atrial rupture, or coronary sinus thrombosis was seen. All PVC lesions were complete as demonstrated by the inability to pace across them. Stained sections demonstrated that acutely studied incision lesions were thinner than RF lesions; however, all lesions were transmural and similar in width at 1 month. Conclusions. RF ablation consistently created transmural lesions more quickly than the incision and suture method and without additional complications. Endocardial RF ablation appears to be a simple and effective alternative to surgical incisions during open-heart atrial Maze procedures.

AB - Background. Radiofrequency (RF) ablation produces transmural atrial lesions in vitro, and may provide advantages over incisions currently used in maze surgery. This study examines the feasibility, safety, and efficacy of open-heart endocardial RF ablation. Methods. Eighteen sheep (42.8 ± 4.4 kg, age < 2 years) underwent left thoracotomy with placement of pacing leads on a pulmonary vein and the left atrial dome. On cardiopulmonary bypass, lesions were made using incision and suture or a novel RF ablation device in three sites: PVC = circle excluding pulmonary veins, IAB = line across the interatrial bundle, SVC = line from the superior to the inferior vena cava. Pacing across the PVC lesion was attempted to assess the completeness of each lesion. Preselected animals (incision n = 4, RF n = 5) were recovered and pacing attempts were repeated at 1 month. After sacrifice, hearts were sectioned and measured for lesion size and completeness. Results. RF ablation lesions took less time to create (total bypass time: RF 51.8 min vs incision 106 min, P < 0.001). No evidence of thromboembolism, atrial rupture, or coronary sinus thrombosis was seen. All PVC lesions were complete as demonstrated by the inability to pace across them. Stained sections demonstrated that acutely studied incision lesions were thinner than RF lesions; however, all lesions were transmural and similar in width at 1 month. Conclusions. RF ablation consistently created transmural lesions more quickly than the incision and suture method and without additional complications. Endocardial RF ablation appears to be a simple and effective alternative to surgical incisions during open-heart atrial Maze procedures.

KW - Ablation

KW - Animal

KW - Arrhythmia

KW - Atrial fibrillation

KW - Endocardial

KW - Maze

KW - Radiofrequency

KW - Sheep

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=0035746604&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035746604&partnerID=8YFLogxK

U2 - 10.1006/jsre.2001.6094

DO - 10.1006/jsre.2001.6094

M3 - Article

C2 - 11319876

AN - SCOPUS:0035746604

VL - 97

SP - 27

EP - 33

JO - Journal of Surgical Research

JF - Journal of Surgical Research

SN - 0022-4804

IS - 1

ER -