Delayed Electroanatomic Mapping After Surgical Ablation for Persistent Atrial Fibrillation

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F60076658%3A12110%2F17%3A43896018" target="_blank" >RIV/60076658:12110/17:43896018 - isvavai.cz</a>

Result on the web

<a href="http://dx.doi.org/10.1016/j.athoracsur.2017.05.018" target="_blank" >http://dx.doi.org/10.1016/j.athoracsur.2017.05.018</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.athoracsur.2017.05.018" target="_blank" >10.1016/j.athoracsur.2017.05.018</a>

Result language

angličtina

Original language name

Delayed Electroanatomic Mapping After Surgical Ablation for Persistent Atrial Fibrillation

Original language description

Background. Long-term efficacy of catheter-based treatment of persistent atrial fibrillation is unsatisfactory. Minimally invasive surgical ablation techniques have been developed recently but their true efficacy has never been systematically tested. Methods. Seventy patients (median age 63.5 years) with persistent atrial fibrillation underwent epicardial thoracoscopic radiofrequency pulmonary vein (PV) isolation, linear ablation, Marshal ligament disruption, and exclusion of the left atrial appendage. The procedure was followed by electroanatomic mapping 2 to 3 months later. Results. Only 76% of patients were in sinus rhythm at the beginning of electroanatomic mapping. Right PVs were found isolated in a higher proportion of patients compared with left PVs (75.7% versus 91.4%, p &lt; 0.001). All four PVs and the left atrial posterior wall were isolated in 68.6% and 22.9% of patients, respectively. Most of the gaps around left PVs were localized in the superior and anterior quadrants, whereas in right PVs, the gaps were found predominantly on the roof and posterior wall. A typical site of reconduction on the inferior connecting line was the segment adjacent to the right inferior PV. No typical reconduction sites were found on the roof line, as 58.5% of patients required completion of the roof line along its full length. Conclusions. Epicardial PV isolation was successful in the majority of patients, but was underwhelming with regard to isolation of the left PVs. Effective epicardially placed linear lines were rare. Our results highlight the significant limitations associated with a single-stage surgical approach and underline the necessity for a two-staged hybrid approach in the treatment of persistent atrial fibrillation. (C) 2017 by The Society of Thoracic Surgeons

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30212 - Surgery

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2017

Confidentiality

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

Name of the periodical

Annals of Thoracic Surgery

ISSN

0003-4975

e-ISSN

—

Volume of the periodical

104

Issue of the periodical within the volume

6

Country of publishing house

US - UNITED STATES

Number of pages

6

Pages from-to

2024-2029

UT code for WoS article

000415802000054

EID of the result in the Scopus database

2-s2.0-85026289607