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J Thorac Cardiovasc Surg 2000;120:164-172
© 2000 The American Association for Thoracic Surgery

SURGERY FOR ACQUIRED CARDIOVASCULAR DISEASE

In vivo and in vitro study of radio-frequency application with a new long linear probeImplication for the maze operation

From the First Department of Internal Medicine^a and Institute of Health Science^b Kyushu University, Fukuoka, Japan.

Address for reprints: Eimei Shimoike, MD, The First Department of Internal Medicine, Kyushu University School of Medicine, Maidashi 3-1-1, Higashi-ku, Fukuoka, Japan 812-8582 (E-mail: eimei{at}med.kyushu-u.ac.jp ).

Background: The maze operation for atrial fibrillation is effective but highly invasive. We tested, both in vitro and in vivo, a new technique for creating long linear atrial lesions with a custom-made, 25-mm long, stainless-steel, linear probe and a corresponding 500-kHz generator for assistance in the maze operation.
Methods: In the in vitro study with the isolated canine atria, the power of the delivered radio-frequency energy and the saline irrigating flow rate were changed independently, and the sizes of the lesions were measured. In the in vivo study radio-frequency energy was delivered to 4 portions (ie, the smooth and trabeculated portions of the right and left atria). The sizes of the lesions were measured, and the histologic features of the lesions were examined. Electrical isolation of the right atrial appendage from the remaining right atrium was attempted by using this linear probe.
Results: In the in vitro study the size of the lesion became larger as the delivered power was increased, although the lesion was limited when the flow rate was high. In the in vivo study the size of the lesion was equal at the 4 different sites. Histologic examinations demonstrated linear and transmural lesions, and electrophysiologic examinations revealed conduction block between the right atrial appendage and the remaining right atrium.
Conclusions: The new original long linear probe was effective for creating transmural linear atrial lesions with the irrigation method, presenting the possibility of an intraoperative technique that mimics the maze procedure.

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