Anatomical pitfalls during encircling cryoablation of the left atrium for atrial fibrillation therapy in the pig.

We previously published encircling endocardial cryo-isolation of the pulmonary vein (PV) region. This study documented mechanisms of isolation failure using CARTO mapping. Cryo-isolation used a modified Surgifrost introduced via a Universal Cardiac Introducer on the left atrial appendage.

En bloc exclusion of the pulmonary vein region in the pig using off pump, beating, intra-cardiac surgery: a pilot study of minimally invasive surgery for atrial fibrillation.

Background: Off-pump, closed, beating heart, minimally-invasive surgery in patients with lone atrial fibrillation (AF) must be effective to become the preferred alternative to catheter ablation. Because of the inherent anatomical limitations of the epicardial access, we explored the feasibility of an intracardiac approach.

Methods: We report an acute study of en bloc, cryo-exclusion of the pulmonary vein region in 7 pigs.

Angiographic, pathologic, and clinical relationships in coronary artery disease in cardiac allografts.

Background: To date, the etiologic factors involved in the development of allograft coronary disease remain speculative and the treatment uncertain. The purpose of this study was to review the relationship of clinical, angiographic, and pathologic features of cardiac allograft vascular disease in a large population of heart transplant recipients followed for up to 15 years.

Methods: From 1981 to 1996, 789 angiograms from 255 cardiac allografts were reviewed to determine the prevalence and severity of coronary artery disease.

Safety and feasibility of cryothermal ablation within the mid- and distal coronary sinus.

Introduction: The aim of this study was to assess the safety and feasibility of catheter-based cryothermal ablation lesions in the mid- and distal coronary sinus.

Methods And Results: Cryothermal ablation lesions were delivered using a 7-French catheter at the mid- (n = 13) and distal (n = 12) coronary sinus in 14 swine under general anesthesia. Lesions were delivered for 2 or 4 minutes in a 1:2 randomized ratio such that seven 2-minute lesions and eighteen 4-minute lesions were delivered to a maximum negative temperature of -70 degrees C.

Role of the posterior left atrium and pulmonary veins in human lone atrial fibrillation: electrophysiological and pathological data from patients undergoing atrial fibrillation surgery.

Background: Surgery can eliminate atrial fibrillation (AF), but data confirming the rationale for specific lesion sets are lacking. We used postoperative electrophysiological studies to test the rationale and effects of operative pulmonary venous isolation.

Methods And Results: Fourteen patients undergoing surgical pulmonary venous isolation for drug-refractory lone AF were studied.