Surgical treatment of atrial fibrillation using radiofrequency energy

Background. The Maze III procedure for atrial fibrillation (AF) is effectiv e but has not been used widely due to its complexity, bleeding risk, and ad ded operative time. Surgical radiofrequency ablation may simplify the proce dure and make intraoperative correction of AF more accessible and widely pe rformed. Methods. Endocardial pulmonary venous isolation was performed on 48 patient s with AF undergoing concurrent operation using temperature-controlled radi ofrequency energy delivered through a hand-held flexible probe. Additional right-sided lesions were made at the surgeon's discretion. Results. Forty-two patients were appropriate for analysis (6 died). These p atients had an AF duration of 4.8 +/- 6.4 years. At a mean follow-up of 138 +/- 96 days, 34 patients were in sinus rhythm. We were unable to demonstra te a difference in outcome based on AF duration, left atrial size, or addit ion of right-sided lesions. Conclusions. Radiofrequency atrial ablation was effective in 81% of patient s with AF at restoring sinus rhythm at an average follow-up of 4 months. Th is procedure is simple to perform and should broaden the number of patients that receive an AF treatment procedure during concurrent cardiac operation . (C) 2001 by The Society of Thoracic Surgeons.