1. Thoracoscopic epicardial ablation of atrial fibrillation: Safety, efficacy, single center experience.
- Author
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Troubil M, Simek M, Juchelka J, Steriovsky A, Hajek R, and Santavy P
- Subjects
- Humans, Middle Aged, Aged, Treatment Outcome, Quality of Life, Prospective Studies, Recurrence, Atrial Fibrillation, Catheter Ablation adverse effects, Catheter Ablation methods
- Abstract
Aims: Atrial fibrillation (AF) is associated with reduced quality of life and increased risk of ischaemic cerebrovascular events. The left atrial epicardial ablation procedures have evolved towards a successful and safe rhythm control strategy for patients with symptomatic drug-refractory paroxysmal, persistent or post-ablation AF or with a high risk of catheter ablation failure. The aim was to evaluate the efficacy and safety of thoracoscopic ablation at our instituiton., Methods: We observed 81 patients undergoing thoracoscopic ablation from January 2015 to December 2019., Results: The mean age was 61.3±8.5 years and the average duration of AF was 3.1±2.6 years. The cohort consisted of 16.5% of paroxysmal AF, 36.7% persistent, and 46.8% of long-standing AF. The procedure was completed in 79 patients; during follow-up, 15 patients (19%) received radiofrequency ablation. Freedom from atrial arrhythmia recurrence was 55.7% after a follow-up (FUP) period of 3.1±1.4 years. At the follow-up visit, sinus rhythm was present in 81% of patients. No relationships between arrhythmia recurrence and BMI, LVEF, left atrial dimension, gender, and AF duration were found. Major complications were noticed in 4 patients (5.0%); 2 had peripheral embolisation, 2 patients were converted to a sternotomy. At the time of the FUP visit, 25.3% of patients were using antiarrhythmic and 74.7% were still using anticoagulants., Conclusion: In the majority of patients, sinus rhythm remained despite a considerable atrial tachycardia recurrence rate, with a relatively low percentage of patients on antiarrythmic drugs., Competing Interests: The authors report no conflicts of interest in this work.
- Published
- 2023
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