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1、MicrowaveAblationForChronicAtrialFibrillationLiPoa,M.D.,F.A.C.S.DirectorofPerioperativeServicesEnloeMedicalCenterChico,CaliforniaTheFutureofCardiacIntervention(NationalHealthCouncil)Stentandintravascularinterventionexpectedtodoubleovernext3yearsCABGvolumetodeclineabout10%withcardiacsurgeryprima
2、rilyexpandinginEPSandCHFsuchasablativesurgery,biventricularpacing,LVremodeling,andcardiacmuscleaugmentation.Valvularvolumetoincreaseabout20%by2005ChronicAtrialFibrillationAffects2millionpeopleintheUSalonewitha9%5yearmorbidityfromanticoagulationanda5%/yearriskofstrokeAshighasan80%riskofstrokeat8
3、yearsintheJapanesestudygroup(Kitamura)Availabletreatmentmodalitiesincludesurgical“Maze”,cryotherapy,radiofrequency,irrigatingradiofrequency,microwave,andlaserSurgicalMazesuccessbestoverallbutMicrowavehastheleastcomplicationsandthebesteaseofuseMicrowaveAblation:~3000patientsOpenHeart2300patients
4、75%success-0to4yearfollowupBeatingHeart–Off-Pump700patients80%success-0to2yearfollowupNoadverseeventsMIS–Off-PumpMiniThoracotomy3casesRobotic2casesThoracoscopy2cases2cm-FLEX2TM4cm-FLEX4TM7cm-FLEX7“...specimenswerecharacterizedbymyocellulardamageinvolvingthefullthicknessoftheatrialwall,wherethic
5、knessrangedfrom4-5mmto1cm.”ClinicalHistopathologyandUltrastructuralAnalysisofMyocardiumfollowingMicrowaveEnergyAblationEricManasseMD,PiergiuseppeColomboMD,PaolaBraidottiPhD,MassimoRoncalliMD-PhD,RobertoGallottiMD(submittedtotheAnnalsofTh.Surg.)from:InVitroandInVivoEvaluationoftheThermalPatterns
6、andLesionsofCatheterAblationwithaMicrowaveMonopoleAntennaDavidKeaneMD,Ph.D.,JeremyRuskinMD,NancyNorris,Pierre-AntoineChapelon,DanyBerube,Ph.D.Beating-HeartSurgeryEpicardialablationEndocardialviewTransmuralLesionViableTissueBeating-HeartSurgeryDr.Maessen-Maastricht,Netherlands(Off-pump)40patient
7、s(32cAF,8pAF)acutedischargeFU40/4026/3932/39(82%)10patients8-11months10patients6-8months19patients0-6monthsPresentedatISMICS-2002n=31(mitralvalve)26/31(84%)insinusrhythmDr.Zembala-Zabrze,Poland(ArrestedHeart)PresentedatCTT-200229p
