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Ann Thorac Surg 2002;73:1160-1168
© 2002 The Society of Thoracic Surgeons

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Original article: cardiovascular

Validation of a left atrial lesion pattern for intraoperative ablation of atrial fibrillation

^a Departments of Cardiovascular Surgery and Electrophysiology, Sinai Samaritan and St. Luke’s Medical Centers, Milwaukee, Wisconsin, USA

Accepted for publication November 20, 2001.

* Address reprint requests to Dr Kress, Midwest Heart Surgery Institute, 2901 West Kinnickinnic River Parkway, Suite 511, Milwaukee, WI 53215, USA
e-mail: dkress{at}execpc.com

Background. Evidence that atrial fibrillation may begin in early stages from triggers or reentry circuits primarily in the left atrium suggests that the entire Maze 3 lesion pattern may be unnecessary. In the present study we describe a new left atrial lesion pattern for intraoperative linear ablation of chronic atrial fibrillation.

Methods. Endocardial radiofrequency ablation was performed on 12 dogs with chronic atrial fibrillation. Lesions to isolate pulmonary veins in pairs, the left atrial appendage, and connecting lesions between these structures were administered in a randomized approach.

Results. Twelve dogs were in chronic atrial fibrillation for 31 ± 21 days before ablation. Atrial fibrillation was successfully ablated and rendered noninducible in all 12 dogs. All treatment failures observed with less than the full lesion pattern became a success when the remaining lesions were given.

Conclusions. Atrial fibrillation ablation using this left atrial lesion pattern is highly successful in this model. This approach may have significant utility as a concomitant procedure for patients with atrial fibrillation undergoing mitral valve procedures.

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