The Treatment of Atrial Fibrillation Using a Novel Energy Source, High Intensity Focused Ultrasound

Sanjay A. Samy, Harold L Lazar, Oz M. Shapira, Curtis T. Hunter, Richard J. Shemin
Boston Medical Center, Boston, MA

Objective: Evaluation of high intensity focused ultrasound (HIFU), a novel energy source, for the treatment of atrial fibrillation.
Design: Consecutive series of the initial 12 patients undergoing HIFU Maze procedure for atrial fibrillation. Patients were followed with postoperative EKG’s ranging from seven days to seventy-two days.
Setting: Tertiary care referral center. Patients: 12 patients, 8 men and 4 women, average age 61.2 years underwent a Maze procedure with HIFU. The patients were grouped: Group I HIFU alone (2), Group II with CABG/HIFU (3), Group III with CABG/valve/HIFU (2) and Group IV with valve/HIFU (5). Average length of follow up was 30 days. Interventions:After incising the pericardium, HIFU was performed by passing an ultrasound band through the transverse sinus, under the left atrial appendage, around the apex of the heart, and through the oblique sinus, thereby isolating the pulmonary veins. After heparin administration 10 minutes of HIFU isolated the pulmonary veins and a 1-minute HIFU to connect the pulmonary vein isolation to the mitral annulus. All patients were started on amiodarone and coumadin postoperatively. Main Outcome Measures: Return to normal sinus rhythm on post operative EKG.
Results: 100% of patients in Group I, 33% in Group II, 0% in Group III and 80% in Group IV returned to sinus rhythm.
Conclusions: Patients with atrial fibrillation alone or only concomitant valve disease were most likely to return to normal sinus rhythm within the first 30 days. Further follow-up will monitor cardiac rhythm in the patients with ischemic heart disease.

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