Ablation of Ganglionic Plexi During Combined Surgery for Atrial Fibrillation Nicolas Doll, MD, PhD, Patrick Pritzwald-Stegmann, MD, Markus Czesla, MD,

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Ablation of Ganglionic Plexi During Combined Surgery for Atrial Fibrillation Nicolas Doll, MD, PhD, Patrick Pritzwald-Stegmann, MD, Markus Czesla, MD, Joerg Kempfert, MD, Monika Anna Stenzel, MD, Michael A. Borger, MD, PhD, Friedrich-Wilhelm Mohr, MD, PhD The Annals of Thoracic Surgery Volume 86, Issue 5, Pages 1659-1663 (November 2008) DOI: 10.1016/j.athoracsur.2008.06.077 Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Schematic human heart; posterior view. General anatomical location of ganglionic plexi indicated by the black dots. These are contained in the “fat pads” that the surgeon visualizes. (GP = ganglionic plexus; IVC = inferior vena cava; LV = left ventricle; PA = pulmonary artery; RV = right ventricle; SVC = superior vena cava). (Adapted from Gross and microscopic anatomy of the human intrinsic cardiac nervous system, Anat Rec, Vol 247, No 2, 1997, 289–98. Copyright © 1997. Reprinted with permission of Wiley-Liss Inc, a subsidiary of John Wiley & Sons, Inc.) The Annals of Thoracic Surgery 2008 86, 1659-1663DOI: (10.1016/j.athoracsur.2008.06.077) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Stimulation of ganglionic plexus (GP) with resultant vagal response before ablation. (B) Stimulation of GP after ablation without a resultant vagal response. The Annals of Thoracic Surgery 2008 86, 1659-1663DOI: (10.1016/j.athoracsur.2008.06.077) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions