The "box" lesion in the modified maze procedure for the surgical treatment of atrial fibrillation

Shi Min Yuan*, Leonid Sternik

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objectives: In surgical treatment of atrial fibrillation, transmurality of the ablation lesions remains the key point of the durability of the maneuver. In the replace of the traditional Maze procedure, a "Box" lesion with bipolar radiofrequency ablator has emerged as a novel technique substituting the usual bilateral epicardial isolation of the pulmonary veins. The aim of the presentstudy was to describe the preliminary utilization of Medtronic devices in making a "Box"lesion in comparison with that produced by Flex 4/10 reported in the literature. Patients and methods: Between February 2004 and March 2011, 58 patients with atrial fibrillation were operated on for a Maze procedure with a "Box" lesion using a bipolar radiofrequency device. Results: Epi- and endocardial lesions were produced on the arrested heart. A sinus rhythm rate was 88%, 94%, and 85% at 3, 6 and 12 months, respectively with no postoperative amiodarone use. Conclusions: Our results of better radiofrequency ablation success rate and sinus rhythm rate emphasize how important is the strategy in doing a better transmurality lesion with the epi- and endocardial bipolar energy source, along with the left atrial isthmus line to the mitral valve.

Original languageEnglish
Pages (from-to)67-70
Number of pages4
JournalActa Medica Mediterranea
Issue number1
StatePublished - 2013
Externally publishedYes


  • Amiodarone
  • Atrial fibrillation
  • Cardiac arrhythmias
  • Cardiac surgical procedures


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