Current status and prospect of off-pump pulmonary vein isolation for atrial fibrillation

We reviewed our clinical experience in off-pump pulmonary vein isolation (PVI) using bipolar radiofrequency (RF) device for atrial fibrillation (Af). From August 2004 to July 2007, the combined off-pump PVI and coronary artery bypass grafting (CABG) was performed in 13 of the 22 planned patients. There was no operative mortality or major complication. Sinus rhythmus was established in 69.2% of the patients [paroxysmal Af (PAf), 8/8 patients; chronic Af, 1/5 patients]. Off-pump PVI using bipolar RF may not be indicated to the chronic Af due to the low curability, and bipolar RF is not safe, especially in case with cardiomegaly or low cardiac function. We developed novel technique using RF thermal balloon catheter for off-pump PVI and evaluated the technique in experimental model. Off-pump PVI with RF thermal balloon catheter was considered to be a safe and effective method to ablate the left atrium-pulmonary vein (LA-PV) antrum circumferentially.