Stand alone totally endoscopic epimyocardial ablation in patients with persistent atrial fibrillation and significant atrial dilatation
Standard
Stand alone totally endoscopic epimyocardial ablation in patients with persistent atrial fibrillation and significant atrial dilatation. / Wagner, Florian Mathias; Pecha, Simon; Conradi, Lenard; Reichenspurner, Hermann.
In: J CARDIAC SURG, Vol. 30, No. 5, 05.2015, p. 469-473.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Stand alone totally endoscopic epimyocardial ablation in patients with persistent atrial fibrillation and significant atrial dilatation
AU - Wagner, Florian Mathias
AU - Pecha, Simon
AU - Conradi, Lenard
AU - Reichenspurner, Hermann
N1 - © 2015 Wiley Periodicals, Inc.
PY - 2015/5
Y1 - 2015/5
N2 - BACKGROUND: To analyze safety and efficacy of surgical totally endoscopic epimyocardial ablation in patients (pts) turned down for interventional catheter therapy due to long-standing persistent atrial fibrillation (pAF) combined with significant atrial dilatation (> 5 cm).METHODS: Since December 2010, 15 pts were referred for surgical ablation due to persistent AF combined with biatrial dilatation (left atrium [LA] 5.0 ± 0.6 cm). Mean age was 52 ± 6 years, body mass index (BMI) 38 ± 6, duration of AF 2.8 ± 1.2 years, left ventricular end diastolic diameter (LVEDD) 5.8 cm ± 0.6 cm. Ablation was performed via a bilateral endoscopic approach using bipolar RF energy application. Monitoring was achieved by an event recorder (Reveal XT Medtronic, Inc., Minneapolis, MN, USA) or repeated 24-hours Holter electrocardiogram.RESULTS: All pts successfully received bilateral pulmonary vein isolation + box lesion + trigonal lesion + left atrial appendage resection. Mean duration of procedure was 235 ± 70 minutes. There was no intraoperative complication; however, one patient had persistent left phrenic nerve palsy. Mean hospital stay was 4 ± 2 days, mean follow-up time was 21 ± 11 months. Incidence of sinus rhythm (SR) was 67, 73, and 80% at discharge, three months, and 12 months follow-up. Mean LA diameter was reduced from 58.1 mm ± 6.0 mm preoperative to 49.7 mm ± 5.4 mm (p = 0.004) at 12 months follow-up. Incidence of SR was 86% at latest follow-up (mean time 21 months). All pts currently in SR (13/15 = 86%) are of class I or III antiarrhythmic drugs.CONCLUSION: Totally endoscopic left atrial ablation including left atrial resection can safely be performed. It achieved excellent rates of SR restoration in patients with long-standing persistent AF combined with significant atrial dilatation.
AB - BACKGROUND: To analyze safety and efficacy of surgical totally endoscopic epimyocardial ablation in patients (pts) turned down for interventional catheter therapy due to long-standing persistent atrial fibrillation (pAF) combined with significant atrial dilatation (> 5 cm).METHODS: Since December 2010, 15 pts were referred for surgical ablation due to persistent AF combined with biatrial dilatation (left atrium [LA] 5.0 ± 0.6 cm). Mean age was 52 ± 6 years, body mass index (BMI) 38 ± 6, duration of AF 2.8 ± 1.2 years, left ventricular end diastolic diameter (LVEDD) 5.8 cm ± 0.6 cm. Ablation was performed via a bilateral endoscopic approach using bipolar RF energy application. Monitoring was achieved by an event recorder (Reveal XT Medtronic, Inc., Minneapolis, MN, USA) or repeated 24-hours Holter electrocardiogram.RESULTS: All pts successfully received bilateral pulmonary vein isolation + box lesion + trigonal lesion + left atrial appendage resection. Mean duration of procedure was 235 ± 70 minutes. There was no intraoperative complication; however, one patient had persistent left phrenic nerve palsy. Mean hospital stay was 4 ± 2 days, mean follow-up time was 21 ± 11 months. Incidence of sinus rhythm (SR) was 67, 73, and 80% at discharge, three months, and 12 months follow-up. Mean LA diameter was reduced from 58.1 mm ± 6.0 mm preoperative to 49.7 mm ± 5.4 mm (p = 0.004) at 12 months follow-up. Incidence of SR was 86% at latest follow-up (mean time 21 months). All pts currently in SR (13/15 = 86%) are of class I or III antiarrhythmic drugs.CONCLUSION: Totally endoscopic left atrial ablation including left atrial resection can safely be performed. It achieved excellent rates of SR restoration in patients with long-standing persistent AF combined with significant atrial dilatation.
KW - Aged
KW - Atrial Fibrillation/pathology
KW - Catheter Ablation/methods
KW - Dilatation, Pathologic
KW - Feasibility Studies
KW - Female
KW - Follow-Up Studies
KW - Heart Atria/pathology
KW - Humans
KW - Male
KW - Middle Aged
KW - Myocardium
KW - Retrospective Studies
KW - Thoracoscopy/methods
KW - Treatment Outcome
U2 - 10.1111/jocs.12523
DO - 10.1111/jocs.12523
M3 - SCORING: Journal article
C2 - 25754505
VL - 30
SP - 469
EP - 473
JO - J CARDIAC SURG
JF - J CARDIAC SURG
SN - 0886-0440
IS - 5
ER -
