| Title: |
Thoracoscopic Pulmonary Vein and Left Atrial Posterior Wall Isolation Combined with Left Atrial Appendage Resection in Patients with Long-Standing Persistent Atrial Fibrillation |
| Authors: |
Aleksandr Zotov, Sergei Vachev, Daniil Borisov, Aleksandr Troitskiy, Robert Khabazov |
| Source: |
Brazilian Journal of Cardiovascular Surgery, Vol 35, Iss 1, Pp 22-27 (2020) |
| Publisher Information: |
Sociedade Brasileira de Cirurgia Cardiovascular, 2020. |
| Publication Year: |
2020 |
| Collection: |
LCC:Surgery
LCC:Diseases of the circulatory (Cardiovascular) system |
| Subject Terms: |
Atrial Fibrillation, Pulmonary Veins, Ischemic Attack, Transient, Sternotomy, Thoracotomy, Myocardial Infarction, Postoperative Complications, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701 |
| More Details: |
Abstract Objective: To evaluate the efficacy and safety of a modified technique for totally thoracoscopic left atrial posterior wall and pulmonary vein isolation in patients with long-standing persistent atrial fibrillation. Methods: From April 2017 to December 2018, we included in this study 28 consecutive patients who underwent thoracoscopic left atrial posterior wall and pulmonary vein radiofrequency isolation combined with left atrial appendage resection. We used a device with irrigated electrodes (Medtronic Cardioblate Gemini-s). The original surgical technique “GALAXY” proposed by Doty in 2012 was modified. The number of ablations was significantly increased, and frequent position changing of the ablation device and change of device angulation were added. Results: Sinus rhythm was restored in all patients. There was no operative mortality, no myocardial infarction, and no stroke or transient ischemic attack. One patient required sternotomy and another survived left anterolateral thoracotomy due to bleeding. A 180-day follow-up (24-hour Holter monitoring) revealed no sign of recurrence of atrial fibrillation or other supraventricular arrhythmia in any patient. Mean follow-up was nine months (range: 6-16 months). At the last follow-up, 26 patients (92,9%) were in sinus rhythm (24-hour Holter monitoring). Conclusion: A frequent ablation device position changing during the surgery makes it possible to achieve complete left atrial posterior wall and pulmonary veins isolation. An increased number of applications allows to avoid a false positive transmural damage assessment showed by impedance drop. Also, frequent position changing of the ablation device and increased number of applications do not affect the number of postoperative complications. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1678-9741 |
| Relation: |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382020000100022&tlng=en; http://www.scielo.br/pdf/rbccv/v35n1/0102-7638-rbccv-2019-0132.pdf; https://doaj.org/toc/1678-9741 |
| DOI: |
10.21470/1678-9741-2019-0132 |
| Access URL: |
https://doaj.org/article/46f308e0a20a4d7cb94cfa99069f71a4 |
| Accession Number: |
edsdoj.46f308e0a20a4d7cb94cfa99069f71a4 |
| Database: |
Directory of Open Access Journals |
