Impact of beating heart left atrial ablation on left-sided heart mechanics Takeyoshi Ota, MD, PhD, David Schwartzman, MD, David Francischelli, MS, Douglas.

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Presentation transcript:

Impact of beating heart left atrial ablation on left-sided heart mechanics Takeyoshi Ota, MD, PhD, David Schwartzman, MD, David Francischelli, MS, Douglas A. Hettrick, PhD, Marco A. Zenati, MD The Journal of Thoracic and Cardiovascular Surgery Volume 134, Issue 4, Pages 982-988 (October 2007) DOI: 10.1016/j.jtcvs.2007.04.063 Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Ablation lesions, encircling lesions (dashed circles), and linear lesions (dashed lines, A-C). Approximate atriotomy sites (•) required for access of 1 of the jaws of the ablation device during deployment of linear lesions (see text). Approximate sites (Ω) of pacing to assess for exit conduction block after encircling lesions (see text). LAA, Left atrial appendage; LPV, left pulmonary veins; RPV, right pulmonary veins; MV, mitral valve. The Journal of Thoracic and Cardiovascular Surgery 2007 134, 982-988DOI: (10.1016/j.jtcvs.2007.04.063) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Typical examples of passive (no perturbation; left) and active (inferior caval constriction; right) LA (top row) and LV (bottom row) pressure (Y axis, in millimeters of mercury)-volume (X axis, in milliliters) relationships. The LA relationships demonstrate typical bifid morphology containing “A loop” (demarcating atrial booster pump function) and “V loop” (demarcating passive changes in LA pressure and volume generated by LV activity). End-systolic elastance was measured for each chamber as the slope of the line (demonstrated) comprised by connecting end-systolic points of the series of pressure–volume relationships generated during inferior caval constriction.8LA, Left atrial; Ees, end-systolic elastance. The Journal of Thoracic and Cardiovascular Surgery 2007 134, 982-988DOI: (10.1016/j.jtcvs.2007.04.063) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Photographs taken from endocardial vantage demonstrating typical lesion morphologies (post-tetrazolium staining) in territories of smooth (left) and trabeculated (right) endocardial topography. RPV, Right pulmonary vein. The Journal of Thoracic and Cardiovascular Surgery 2007 134, 982-988DOI: (10.1016/j.jtcvs.2007.04.063) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions