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Updated: Feb 2, 2026
11:21
Robotic Ablation of Atrial Fibrillation
Published on: May 29, 2015
20.2K
Noninvasive mapping before surgical ablation for persistent, long-standing atrial fibrillation
Marek P Ehrlich1, Guenther Laufer1, Iuliana Coti1
1Department of Cardiac Surgery, University of Vienna, Vienna, Austria.
The Journal of Thoracic and Cardiovascular Surgery
|November 29, 2018
Summary
Noninvasive mapping revealed biatrial rotor and macro-reentry activity in all patients with persistent atrial fibrillation, guiding surgical ablation for improved outcomes.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Persistent and long-standing persistent atrial fibrillation (AF) present complex electrophysiological mechanisms.
- Surgical ablation, such as the Cox-Maze procedure, is a treatment option for AF, particularly in patients undergoing cardiac surgery.
Purpose of the Study:
- To investigate the electrophysiologic mechanisms of atrial fibrillation using noninvasive 3-dimensional mapping.
- To assess the utility of preoperative mapping in patients undergoing concomitant surgical ablation for AF.
Main Methods:
- A pilot trial involving 10 patients with persistent AF undergoing cardiac surgery.
- Preoperative mapping was performed using a noninvasive surface system (ECVUE).
- Surgical ablation included Cox-Maze III/IV procedure with cryoablation and radiofrequency, and left atrial appendage removal.
Main Results:
- Noninvasive mapping successfully identified AF mechanisms in all patients.
- Biatrial pathology was evident in all subjects.
- Rotor and macro-reentry activity were consistently observed, with rotor activity in the right atrium present in all patients.
Conclusions:
- This study demonstrates the feasibility of preoperative noninvasive mapping in surgical AF patients.
- The findings highlight the biatrial nature of AF mechanisms, supporting comprehensive ablation strategies.
- Preoperative mapping can enhance understanding of AF pathophysiology and personalize surgical ablation approaches.
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