Epicardial electrical isolation of the right atrial appendage on the beating heart with an infrared coagulator.

To determine the clinical efficacy of application of infrared energy to the beating heart as a means of creating electrical blocks, an original infrared coagulator (KIRC-119; Phomec Inc, Tokyo, Japan) was applied to the atrium of a patient with atrial fibrillation. A postoperative electrophysiologic study was performed to confirm its efficacy. The coagulator was applied epicardially to the beating heart concomitant with an on-pump beating heart coronary artery bypass graft procedure.

Epicardial maze procedure on the beating heart with an infrared coagulator.

Purpose: Maze surgery is widely used to treat atrial fibrillation (AF) but requires cardiopulmonary bypass and longer aortic cross-clamping time. Percutaneous transcatheter pulmonary vein (PV) isolation is time consuming and relies on fluoroscopy and contrast media, and PV obstruction and cardiac tamponade are still major problems. To overcome these drawbacks, we developed an epicardial maze procedure with an infrared coagulator on the beating heart, and the aim of this study was to confirm electrophysiologically the efficacy of this method.

Epicardial pulmonary vein isolation with a hook-shaped cryoprobe to treat atrial fibrillation.

Purpose: After it was shown that a rapidly firing focus in a pulmonary vein (PV) can cause atrial fibrillation, percutaneous endocardial PV isolation using radiofrequency began to be used as a method of treatment. However, this technique is time consuming. It requires fluoroscopy and contrast media to identify the PV, and cardiac tamponade and PV obstruction are major complications.