Atricure bipolar radiofrequency clamp for intraoperative ablation of atrial fibrillation

Purpose. This work reports our initial evaluation and clinical experience with the Atricure bipolar radiofrequency (RF) system for intraoperative ablation of atrial fibrillation (AF). Description. The Atricure system includes a bipolar RF clamp and an RF generator. Lines of conduction block are created by delivery of RF energy (75 volts, 750 milliamps) to tissue compressed between the jaws of the clamp. Energy delivery is continued until the lesion is transmural, indicated by steady and reduced conductance between electrodes in the clamp. Evaluation. The Atricure device was used for intraoperative treatment of AF in 120 patients. Lesion sets varied, as the device was used for pulmonary vein isolation, creation of right atrial lesions, or both. There were no device-related complications. Initial incomplete pulmonary vein isolation, identified by pacing, was uncommon, occurring with very thick atrial tissue and when tightening the clamp caused tissue to become folded upon itself in the jaws or to extrude beyond the jaws of the clamp. In such cases, reapplication of the RF clamp produced complete pulmonary vein isolation. Conclusions. The Atricure bipolar RF system facilitates surgical treatment of AF. Proper application of the clamp is essential to ensure continuous transmural lesions.