Epicardial radiofrequency ablation for chronic atrial fibrillation undergoing simultaneous on-pump beating coronary artery bypass grafting

Area of Science:

• Cardiovascular Surgery
• Cardiac Electrophysiology

Background:

• Off-pump coronary artery bypass grafting (OPCAB) is a myocardial revascularization technique offering myocardial protection.
• Coronary artery disease (CAD) frequently coexists with atrial fibrillation (AF), a common arrhythmia.
• Surgical treatment for AF, such as the Cox-Maze III procedure, is often not performed concurrently with coronary bypass grafting.

Observation:

• A case involving a patient with chronic AF requiring coronary revascularization is presented.
• The patient underwent a combined surgical procedure.
• This involved epicardial radiofrequency ablation for pulmonary vein isolation to treat AF.

Findings:

• Pulmonary vein isolation was successfully achieved using epicardial radiofrequency ablation.
• The patient underwent two-vessel coronary artery bypass grafting on a beating heart.
• Cardiopulmonary bypass was utilized to facilitate the combined procedure.

Implications:

• This combined approach offers a potential solution for patients with CAD and concurrent AF.
• It demonstrates the feasibility of integrating AF ablation with OPCAB.
• Further research may validate this technique for broader clinical application in managing complex cardiac conditions.