What is the role of radiofrequency (RF) lesions in the surgical compartmentalization of the atria in atrial fibrillation (Afib) (AF)?

Updated: Nov 18, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Answer

As a parallel to the maze procedure, electrophysiologists have attempted to mimic surgical suture lines with radiofrequency (RF) lesions. The procedures tend to last many hours, and success rates have been somewhat disappointing (50-60%), with the occurrence of left atrial reentrant tachycardias and left atrial flutters (requiring further ablation procedures). [129]

Researchers are uncertain which areas of the atria are necessary to sustain AF. Purely right-sided lesions are not sufficient to eliminate AF, making left atrial procedures necessary. In addition, gaps in linear lesions can be difficult to find.

Research currently focuses on catheter design to deliver linear continuous lesions. Additionally, alternative energy sources (eg, cryotherapy, laser, ultrasonography) may improve the ability to deliver transmural lesions in the left atrium.


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