Ablation Via the Left Atrial Appendage

Method Fourteen consecutive patients with long term and short term persistent atrial fibrillation were the basis of this report. On full cardiopulmonary bypass, radiofrequency clamps were applied to the epicardial left atrial tissue surrounding the right and left pulmonary veins, separately. The left atrial appendage was amputated on the arrested heart. Via that defect, an epicardial to endocardial radiofrequency ablation lesion was created with the clamp to the left superior pulmonary vein, then to the right superior pulmonary vein. A cryothermy catheter was then placed to create an endocardial lesion from the left inferior pulmonary vein ablation mark, along the posterior left atrial floor, to the right inferior pulmonary vein. The catheter then connected that floor lesion to the mitral valve annulus at P2-P3. Right atrial lesions were performed in 8 patients in the manner described for the Cox-maze IV operation.