Objective: Intraoperative CARTO Mapping for Atrial Fibrillation ablation in cardiac surgery.
Background: Surgical ablation of Atrial Fibrillation is usually performed without mapping. The study aims to determine if intraoperative CARTO can be useful to guide the ablating procedure.
Methods and Findings: Fourteen patients with symptomatic and drug-refractory concomitant AF were operated on in 2003 and 2004. CARTO mapping was performed before and after surgical bipolar radio-frequency ablation. Application of energy was repeated when residual electrical activity was detected at the pulmonary veins-atrial junction. Pacing wires were applied on right and left pulmonary veins distally to the ablation line to confirm the exit block.
The mapping protocol was completed in 12 patients. Acute left atrium-pulmonary vein isolation was achieved after single or double energy application in 2/12 (16.6%) and 9/12 (75%) patients, respectively. The mean duration of the mapping and ablation procedure was 67 minutes.
At discharge, PV isolation persisted in 10 patients: exit block was confirmed by the absence of pacing through the pulmonary veins electrodes.
After a mean follows up of 181 months, no further recurrent AF events were registered in 9/12 (69.2%) patients.
Conclusions: CARTO system is useful during open-heart surgery to guide the ablating strategy.
A case of an ablation catheter entrapped in the pulmonary vein during atrial fibrillation ablation requiring open heart surgery for removal
