Minimally Invasive Mapping Guided Surgical Treatment of Atrial Fibrillation. Utopia or Near Future?

Isolation of the pulmonary veins has been used as surgical treatment for atrial fibrillation (AF) from the early 90s, as it was incorporated in the Maze procedure. With the evidence that triggers form this area can induce AF, the Maze III procedure has been adapted and modified towards a single lesi...

Full description

Bibliographic Details
Main Authors: Thomas J. van Brakel, Gil Bolotin, M.A. Allessie, Jos G. Maessen
Format: Article
Language:English
Published: Elsevier 2006-10-01
Series:Indian Pacing and Electrophysiology Journal
Subjects:
Online Access:http://www.ipej.org/0604/brakel.htm
_version_ 1818116190296342528
author Thomas J. van Brakel
Gil Bolotin
M.A. Allessie
Jos G. Maessen
author_facet Thomas J. van Brakel
Gil Bolotin
M.A. Allessie
Jos G. Maessen
author_sort Thomas J. van Brakel
collection DOAJ
description Isolation of the pulmonary veins has been used as surgical treatment for atrial fibrillation (AF) from the early 90s, as it was incorporated in the Maze procedure. With the evidence that triggers form this area can induce AF, the Maze III procedure has been adapted and modified towards a single lesion around the pulmonary veins for the treatment of paroxysmal and chronic AF in some centers. New ablation techniques with a diversity of energy sources further paved the way for less invasive procedures. Minimal invasive techniques to prevent major surgery may potentially make the treatment available for a patient population that does not have to undergo cardiac surgery for other reasons. Besides these technical developments, high density mapping can be used to identify the AF substrate in the individual patient and optimization of the treatment by local substrate guided ablation. This review aims to summarize the robotic and thoracoscopic techniques to isolate the pulmonary veins. Furthermore, it is discussed why pulmonary veins isolation may be effective in patients with chronic AF, and whether there is a role for mapping guided minimal invasive surgical treatment of AF in the near future.
first_indexed 2024-12-11T04:18:34Z
format Article
id doaj.art-473d53bb344e4f4ca8fc7152ec8b0c84
institution Directory Open Access Journal
issn 0972-6292
language English
last_indexed 2024-12-11T04:18:34Z
publishDate 2006-10-01
publisher Elsevier
record_format Article
series Indian Pacing and Electrophysiology Journal
spelling doaj.art-473d53bb344e4f4ca8fc7152ec8b0c842022-12-22T01:21:11ZengElsevierIndian Pacing and Electrophysiology Journal0972-62922006-10-0164234241Minimally Invasive Mapping Guided Surgical Treatment of Atrial Fibrillation. Utopia or Near Future?Thomas J. van BrakelGil BolotinM.A. AllessieJos G. MaessenIsolation of the pulmonary veins has been used as surgical treatment for atrial fibrillation (AF) from the early 90s, as it was incorporated in the Maze procedure. With the evidence that triggers form this area can induce AF, the Maze III procedure has been adapted and modified towards a single lesion around the pulmonary veins for the treatment of paroxysmal and chronic AF in some centers. New ablation techniques with a diversity of energy sources further paved the way for less invasive procedures. Minimal invasive techniques to prevent major surgery may potentially make the treatment available for a patient population that does not have to undergo cardiac surgery for other reasons. Besides these technical developments, high density mapping can be used to identify the AF substrate in the individual patient and optimization of the treatment by local substrate guided ablation. This review aims to summarize the robotic and thoracoscopic techniques to isolate the pulmonary veins. Furthermore, it is discussed why pulmonary veins isolation may be effective in patients with chronic AF, and whether there is a role for mapping guided minimal invasive surgical treatment of AF in the near future.http://www.ipej.org/0604/brakel.htmAtrial fibrillationMinimal invasiverobotpulmonary veinsmapping
spellingShingle Thomas J. van Brakel
Gil Bolotin
M.A. Allessie
Jos G. Maessen
Minimally Invasive Mapping Guided Surgical Treatment of Atrial Fibrillation. Utopia or Near Future?
Indian Pacing and Electrophysiology Journal
Atrial fibrillation
Minimal invasive
robot
pulmonary veins
mapping
title Minimally Invasive Mapping Guided Surgical Treatment of Atrial Fibrillation. Utopia or Near Future?
title_full Minimally Invasive Mapping Guided Surgical Treatment of Atrial Fibrillation. Utopia or Near Future?
title_fullStr Minimally Invasive Mapping Guided Surgical Treatment of Atrial Fibrillation. Utopia or Near Future?
title_full_unstemmed Minimally Invasive Mapping Guided Surgical Treatment of Atrial Fibrillation. Utopia or Near Future?
title_short Minimally Invasive Mapping Guided Surgical Treatment of Atrial Fibrillation. Utopia or Near Future?
title_sort minimally invasive mapping guided surgical treatment of atrial fibrillation utopia or near future
topic Atrial fibrillation
Minimal invasive
robot
pulmonary veins
mapping
url http://www.ipej.org/0604/brakel.htm
work_keys_str_mv AT thomasjvanbrakel minimallyinvasivemappingguidedsurgicaltreatmentofatrialfibrillationutopiaornearfuture
AT gilbolotin minimallyinvasivemappingguidedsurgicaltreatmentofatrialfibrillationutopiaornearfuture
AT maallessie minimallyinvasivemappingguidedsurgicaltreatmentofatrialfibrillationutopiaornearfuture
AT josgmaessen minimallyinvasivemappingguidedsurgicaltreatmentofatrialfibrillationutopiaornearfuture