Vol 65, No 4 (2007)
Other
Published online: 2007-04-26
Original article
Minimally invasive off-pump video-assisted endoscopic surgical pulmonary vein isolation using bipolar radiofrequency ablation – preliminary report
DOI: 10.33963/v.kp.80940
Kardiol Pol 2007;65(4):370-374.
Abstract
Background: Atrial fibrillation (AF) is the most common arrhythmia, having a strong impact on long-term stroke and heart failure prevalence and mortality. Nowadays, rapid development in the field of minimising the invasiveness of surgical ablation of AF can be observed. Aim: To report on the feasibility and early results of the first Polish experience with a novel technique of minimally invasive video-assisted beating heart bilateral surgical ablation for lone paroxysmal AF using irrigated bipolar radiofrequency technique. Methods: Between February and December 2006, 6 patients with highly symptomatic paroxysmal AF, resistant to pharmacological treatment, underwent video-assisted beating heart bilateral pulmonary vein isolation using irrigated bipolar radiofrequency combined with vein of Marshall dissection and left atrial appendage closure. In 2 patients at least 2 unsuccessful percutaenous ablations had previously been performed. Results: There were no complications. Ablation time was on average 88±12.1 seconds. At least one recurrence of AF was observed in 4 patients in the early postoperative period; in 3 of them an electrical cardioversion was performed. All patients were discharged home in stable sinus rhythm. Three patients have exceeded 3 months’ observation; one has reached 6 months of observation. All are in stable sinus rhythm and the follow-up course is uneventful. Conclusions: Minimally invasive video-assisted beating heart bilateral surgical ablation for lone paroxysmal AF using irrigated bipolar radiofrequency is effective and safe. These promising results have to be confirmed by larger studies.
Keywords: lone atrial fibrillationsurgical ablationminimally invasiveoff-pumpendoscopic