[HSF] afib theory

[Hgrmd at aol.com]

Tea,
  That was a flood of philosophical mumbo jumbo regarding AF  surgery.  To me
, it's pretty simple stuff.  Just do a set of lines  that you know will work.  
As for the ganglionic ablation, there is scant  evidence that doing it has 
any long term benefit in curing atrial  fibrillation.  Without citing a source, 
I heard Damiano say there was  evidence the ganglia regenerate with time.  
Certainly, Jim Edgerton's  results with ganglionic ablation presented at the last 
STS was less than  impressive.  
  PVI works for intermittent AF.  For persistent or continuous  AF, the 
mitral isthmus lesion and ablation of the coronary sinus are  required.  Cox and 
Damiano insist that a full set of lesions is required  for the right side as 
well.  I'm not convinced, and have had excellent  results with the cavotricuspid 
isthmus lesion only.  However, I may go  ahead and do the full set in the 
future, simply because it's no big deal.
 
Hal



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