A possible surgical technique to avoid esophageal and circumflex artery injuries using radiofrequency ablation to treat atrial fibrillation.

A surgical technique using unipolar radiofrequency ablation is described, which minimizes the risk of damaging adjacent cardiac structures. The left atrium was fully mobilized. Linear, non-thrombogenic, white blistering lesions were created with a hand-held malleable pen-catheter, making oscillating movements, while preserving a stable endocardium contact, without pressing the atrial wall to adjacent mediastinal structures. The ablated atrial tissue was lifted up with forceps. Each pulmonary vein orifice was circumferentially ablated and interconnected on the ipsi- and to the contra-lateral side, and to the left auricle and mitral valve annulus. No esophageal or circumflex artery injuries were observed.