Novel Technique for Box-Lesion Ablation of Atrial Fibrillation Combined with Off-Pump Coronary Surgery

ABSTRACT Introduction: We propose a new technique for box-lesion ablation combined with off-pump coronary artery bypass grafting for the treatment of patients with coronary artery disease and paroxysmal or persistent atrial fibrillation. Methods: Eight male patients with paroxysmal (n=2) or persistent atrial fibrillation (n=6) and coronary artery disease underwent box-lesion ablation combined with off-pump coronary artery bypass grafting. Box-lesion ablation was performed using a bipolar flexible clamping device with irrigated electrodes which was originally designed for thoracoscopic epicardial ablation. Results: Complete revascularization was performed in all patients. There were no deaths or major complications. At a median follow-up of 14 months, seven patients (87.5%) were in sinus rhythm. Conclusion: Box-lesion ablation can be easily and effectively combined with coronary artery surgery in an off-pump setting.

摘要
引言：我们提出一项用于治疗冠状动脉疾病合并阵发性或持续性心房颤动患者的新技术，即盒状病灶消融术（box-lesion ablation）联合非体外循环冠状动脉旁路移植术（off-pump coronary artery bypass grafting）。
方法：8例合并冠状动脉疾病的男性患者，其中阵发性心房颤动患者2例（n=2）、持续性心房颤动患者6例（n=6），接受了盒状病灶消融术联合非体外循环冠状动脉旁路移植术。本次消融操作采用带灌注电极的双极柔性夹持装置，该装置最初为胸腔镜心外膜消融设计。
结果：所有患者均实现完全血运重建，无死亡或严重并发症发生。中位随访14个月时，7例患者（87.5%）维持窦性心律。
结论：盒状病灶消融术可在非体外循环条件下便捷、有效地与冠状动脉外科手术联合开展。