Posted by Sarah on February 02, 2004 at 15:36:41:
In Reply to: Re: Excellent articles and some thoughts..... posted by Bud Viren on February 02, 2004 at 00:12:27:
You wrote: "An EP would only be required to "see" the errant electrical signals in a maze followup if they somehow still leak across the healed incisions."
Exactly. If the burns aren't deep enough, they will continue conducting, and that's when not being able to "see" the Afib impulses (where exactly they are located/coming from) becomes a disadvantage for the Maze surgeon, as apposed to the EP surgeon. My understanding is that no two persons are exactly alike, as far as WHERE the "irritability" causing the errant electrical impulses may be coming from. There are people, who after the curcumferintial linear burns are made around the PV during Maze surgery, find that they also have places conducting Afib in other, sometimes unusual areas of the wall of the left atrium. In the old days of cut & sew method, the surgeon basically cut the same areas (protocol)for ALL hearts, forming the deep scars where it was thought to make the best paths. But it didn't always work, and they found that using EP improved the statistics.
Hence....the use of EP sensor wires, to map the area, so as to make that path/maze in the right place. I'm not sure that "ablation", whether it be cryo, microwave, RF is ever administered with anything BUT a catheter....different kinds of catheters, but all the same...catheters. The cryo ablation I saw at CC during a live Maze surgery, was a catheter type instrument, with a foot pedal,like the RF catheters have.
Whatever,
Sarah