Sinus node-atrioventricular node isolation: long-term results with the "corridor" operation for atrial fibrillation

Area of Science:

• Cardiac Electrophysiology
• Surgical Innovation
• Arrhythmia Management

Background:

• Atrial fibrillation (AF) is a common arrhythmia often refractory to drug therapy.
• The "corridor" operation aims to restore sinus rhythm by isolating specific atrial regions.
• Previous studies on this technique are limited.

Purpose of the Study:

• To evaluate the efficacy and safety of the "corridor" operation for drug-refractory atrial fibrillation.
• To assess long-term outcomes including freedom from AF and need for pacemakers.

Main Methods:

• Nine patients with drug-refractory AF (chronic or paroxysmal) underwent the "corridor" procedure.
• Preoperative and predischarge electrophysiologic studies were performed.
• Follow-up included monitoring for arrhythmia recurrence and device implantation.

Main Results:

• Successful isolation of the sinus and atrioventricular (AV) nodes was achieved in all patients.
• Seven out of nine patients remained free of AF during a mean follow-up of 21 months.
• Four patients required permanent pacemaker implantation due to sinus node dysfunction.

Conclusions:

• The "corridor" operation is a viable option for selected patients with drug-refractory atrial fibrillation.
• While effective in restoring sinus rhythm, potential complications include sinus node dysfunction requiring pacing.
• Further research is warranted to optimize patient selection and procedural techniques.