Interv Akut Kardiol. 2010;9(4):180-184

Minimally invasive thoracoscopic ablation for atrial fibrillation

Marek Pojar¹, Jan Vojáček¹, Luděk Haman², Petr Pařízek²

¹ Kardiochirurgická klinika LF UK a FN Hradec Králové, Kardiocentrum FN HK, Hradec Králové

² I. interní klinika LF UK a FN Hradec Králové, Kardiocentrum FN HK, Hradec Králové

Objective: We report our experiences with new technique of minimally invasive surgical ablation of lone atrial fibrillation.

Methods: There were 8 patients at mean age of 57 ± 11 years who underwent bilateral totally thoracoscopic ablation of symptomatic

paroxysmal AF (6 patients; 75 %) or persistent AF (2 patients; 25 %). Box-lesion ablation procedure included bilateral pulmonary vein

ablation together with the posterior wall of the left atrium using irrigated bipolar radiofrequency with the documentation of conduction

block. Stapling closure of the left atrial appendage was performed in one patient.

Results: There was no intra- or perioperative ablation related complication. Skin-to-skin procedure time was 160 ± 23,5 minutes and the

postoperative average length of stay was 6,9 ± 2,8 days. Sinus rhythm was restored in 6 (75 %) patients, while 2 (25 %) remained in paroxysmal

atrial fibrillation at the discharge. At 3 months follow-up 6/8 (75 %) patients were AF free (according 24 hours ECG Holter). There

have been no strokes or transient ischemic attacks. Pleural effusions occurred in two patients postoperatively.

Conclusion: Early data shows that minimally invasive box-lesion strategy in paroxysmal AF ablation is feasible and safe with promising

early results.

Keywords: atrial fibrillation, thoracoscopy, radiofrequency ablation

Published: October 15, 2010  Show citation