Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Editorial
. 2021 Jun 29:17:79-83.
doi: 10.1016/j.xjtc.2021.06.031. eCollection 2023 Feb.

The maze IV operation is not always the best choice: Matching the procedure to the patient

Patrick M McCarthy  1
Affiliations
Editorial

The maze IV operation is not always the best choice: Matching the procedure to the patient

Patrick M McCarthy. JTCVS Tech. .
No abstract available

Keywords: Cox maze; atrial fibrillation cryoablation; atrial fibrillation surgery; atrial fibrillation surgery lesion set; maze IV.

PubMed Disclaimer

Figures

None
The key focus of ablation for most cardiac surgery patients is the left atrial lesion set.
Figure 1
Figure 1
The left atrial lesion set. The most important focus of ablation for almost all cardiac surgery patients is the left side lesion set. At Northwestern Medicine, we start with epicardial clip application to the left atrial appendage, which also electrically isolates the appendage. Only in the case of extensive pericardial adhesions do we close the left atrial appendage internally. The first 3-minute cryolesion (dashed black line) uses a disposable probe from the superior extent of the atriotomy across the dome of the left atrium, and the base of the appendage, and typically ends at about the P2 location. The second 3-minute cryolesion (red dotted line) extends from the inferior atriotomy, across the end of lesion 1 to complete the box lesion, and the probe is bent to create the mitral annular lesion. The third 2-minute cryolesion (yellow line) is applied on the epicardium across the coronary sinus.
See this image and copyright information in PMC

References

    1. Williams J.M., Ungerleider M.D., Lofland G.K., Cox J.L., Sabiston D.C., Jr. Left atrial isolation: new technique for the treatment of supraventricular arrhythmias. J Thorac Cardiovasc Surg. 1980;80:373–380. - PubMed
    1. Guiraudon G.M., Campbell C.S., Jones D.L., McLellan J.L., MacDonald J.L. Combined sino-atrial node atrio-ventricular node isolation: a surgical alternative to His bundle ablation in patients with atrial fibrillation. Circulation. 1985;72:220.
    1. Cox J.L. A brief overview of surgery for atrial fibrillation. Ann Cardiothorac Surg. 2014;3:80–88. - PMC - PubMed
    1. Gaynor S.L., Diodato M.D., Prasad S.M., Ishii Y., Schuessler R.B., Bailey M.S., et al. A prospective, single-center clinical trial of a modified Cox maze procedure with bipolar radiofrequency ablation. J Thorac Cardiovasc Surg. 2004;128:535–542. - PubMed
    1. McCarthy P.M., Gerdisch M., Philpott J., Barnhart G.R., Waldo A.L., Shemin R., et al. Three-year outcomes of the postapproval study of the AtriCure bipolar radiofrequency ablation of permanent atrial fibrillation trial. J Thorac Cardiovasc Surg. October 3, 2020 [Epub ahead of print] - PubMed

Publication types

LinkOut - more resources