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Atrial Ablation for the Surgical Treatment of Atrial Fibrillation:
Author(s) -
Melo João Q.,
Santiago Teresa,
Gouveia Rosa H.,
Martins Ana P.
Publication year - 2004
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.0886-0440.2004.04038.x
Subject(s) - medicine , atrial fibrillation , percutaneous , cardiology , ablation , sinus rhythm , catheter ablation
This article reviews the development of procedures designed to eradicate atrial fibrillation by creating nonincisional lesions in the atria. Percutaneous interventional and surgical data are reviewed and analyzed. A major limitation of the surgical approaches, which utilize a variety of energy sources, appears to be the difficulty in achieving transmurality in all patients. A second limitation is related to a poor understanding of the underlying mechanisms of atrial fibrillation, and the consequent uncertainty as to the ideal lesion configurations necessary to counter these mechanisms. The article also discusses the various types of clinical atrial fibrillation, and discusses the differences between endocardial and epicardial application of thermal energy sources. Finally, atrial contractility is addressed, and the authors conclude that the ideal procedure will achieve a balance between conversion to normal sinus rhythm and the preservation of atrial contractility. (J Card Surg 2004;19:207‐210)