Figure 14.

Lesion sets of the Cox maze IV procedure. (A) Left atrial lesion set including: (i) left atriotomy, (ii) ablation around the left-sided PVs, (iii) ablation around the right-sided PVs, (iv) posterior wall box lesion, (v) line connecting left PV lesion to excluded LAA, (vi) line connecting box lesion to mitral annulus, (vii) cryoablation to the epicardial ostial region of the coronary sinus (not shown). (B) Right atrial lesion set including: (i) right atriotomy extending over crista terminalis, (ii) line from the atriotomy to the superior and inferior vena cava posterior to the crista terminalis (to avoid injury to the sinoatrial node), (iii) line connecting the atriotomy to the tricuspid annulus (2 o’ clock relative to the valve), and (iv) line connecting the right atriotomy to the right atrial appendage. LAA, left atrial appendage; PV, pulmonary vein.