Treatment of stand-alone atrial fibrillation with a right thoracoscopic approach employing a microwave or monopolar radiofrequency energy source: long-term results

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11120%2F16%3A43911132" target="_blank" >RIV/00216208:11120/16:43911132 - isvavai.cz</a>

Alternative codes found

RIV/00064173:_____/16:N0000215

Result on the web

<a href="http://dx.doi.org/10.1093/icvts/ivw040" target="_blank" >http://dx.doi.org/10.1093/icvts/ivw040</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/icvts/ivw040" target="_blank" >10.1093/icvts/ivw040</a>

Result language

angličtina

Original language name

Treatment of stand-alone atrial fibrillation with a right thoracoscopic approach employing a microwave or monopolar radiofrequency energy source: long-term results

Original language description

OBJECTIVES: Minimally invasive surgery for atrial fibrillation (AF) has rapidly evolved recently. The long-term efficacy of most of these procedures is poorly known. METHODS: Between 2006 and 2010, 38 drug-resistant, symptomatic patients with stand-alone AF underwent unilateral, thoracoscopic, off-pump ablation. The mean age was 60 +- 8.2 (range 42-75) years and the mean AF duration was 46 +- 62 (range 3-240) months. Sixteen patients (42%) had paroxysmal, 9 (24%) had persistent and 13 (34%) had long-standing persistent AF. A box lesion was created using a microwave (26 patients) or monopolar radiofrequency (12 patients) system. Patients were prospectively followed with repeat electrocardiograms (ECGs) and ECG Holters. Additional catheter ablation was offered to patients with recurrence of arrhythmia. RESULTS: All procedures were completed as planned with one conversion to sternotomy, zero mortality and minimal in-hospital complications. The mean follow-up duration was 70 +- 19 (range 20-88) months. Arrhythmia-free survival rates after the procedure were 50, 44.4, 24.1 and 10.8% at 6, 12, 36 and 60 months, respectively, with most recurrences in the first 6 months. Twelve patients underwent additional catheter ablation(s); from the last intervention, 75% of them were in sinus rhythm (SR) with a mean follow-up of 31 +- 23 (range 4-86) months. Overall, at the end of follow-up, only 3 patients were still in SR without any arrhythmia recurrence. Major complications (cerebral, peripheral embolism or bleeding) occurred in 5 patients. CONCLUSIONS: Unilateral, thoracoscopic AF ablation is safe and technically feasible. However, the results of the microwave and monopolar radiofrequency devices were less than satisfactory, with a gradual decline in arrhythmia-free survival over a very long-term follow-up.

Czech name

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Czech description

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Type

J_x - Unclassified - Peer-reviewed scientific article (Jimp, Jsc and Jost)

CEP classification

FA - Cardiovascular diseases including cardio-surgery

OECD FORD branch

—

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2016

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Interactive Cardiovascular and Thoracic Surgery

ISSN

1569-9293

e-ISSN

—

Volume of the periodical

22

Issue of the periodical within the volume

6

Country of publishing house

GB - UNITED KINGDOM

Number of pages

7

Pages from-to

762-768

UT code for WoS article

000377437200012

EID of the result in the Scopus database

2-s2.0-84974555461