Radiofrequency ablation for atrial fibrillation using only a bipolar device

Abstract

Purpose: Although the maze procedure using a radiofrequency ablation device is a prevalent treatment for atrial fibrillation, a bipolar radiofrequency device is generally not used on the mitral and tricuspid annulus owing to the risk of coronary artery injury. We report the performance of the maze procedure using only a bipolar radiofrequency ablation device in our institute since 2009. Methods: We performed the maze procedure using only a bipolar device in 35 patients (bipolar group) and compared their operative outcomes with 56 patients who underwent standard radiofrequency ablation using bipolar and unipolar devices (standard group) for atrial fibrillation. Results: Preoperative characteristics were similar in the two groups. Operative data were also similar in the two groups except for a higher number of concomitant tricuspid valve repairs in the bipolar group (p = 0.007). There were no significant differences in mortality and morbidity between the two groups. Sinus rhythm was restored in a significantly higher number of patients in the bipolar group (71.4%) than in the standard group (39.3%; p = 0.002) at the first postdischarge follow-up. Conclusion: The maze procedure using only a bipolar radiofrequency device can be safely performed and results in a satisfactory sinus rhythm restoration.