Minimally Invasive Cardiothoracic Surgery for Atrial Fibrillation A Combined Japan-US Experience

Thoracoscopic epicardial ablation of the left and right atrium. Beating heart procedure in patients with atrial fibrillation

“…Our results may thus be considered as highly efficient. Matsutani et al 18 reported the presence of the SR in 90% of the patients during the mean follow-up period of 16.6 months after thoracoscopic mini-MAZE ablation. Beside isolation of the pulmonary veins, the procedural technique included ablation of the epicardial autonomic nervous system ganglion plexus and amputation of the left atrial appendage, which might account for slightly better results compared with our study.…”

“…One patient experienced typical atrial flutter after the procedure; the flutter was effectively eliminated by transcutaneous RF, as reported in the previous paper. 21 Matsutani et al 18 reported atrial flutter in 1 patient (5%) following thoracoscopic ablation procedure, requiring transcutaneous ablation. Reddy et al 22 described a case of simultaneous epicardial and endocardial ablation that allowed them to obtain full ablation line within the left atrial posterior wall.…”

Electrophysiological Characteristics of the Marshall Potential in Dogs Based on Anatomic Properties

“…16 Tai et al demonstrated that distal CS pacing can differentiate the Marshall potential from PVPs by causing the Marshall potential to fuse into an atrial electrogram while separating the PVPs from the atrial electrogram. 18 A reverse phenomenon was present in our study during LAA pacing, although complex forms may be present.…”

“…12,15 First, the activation wavefront may proceed from the CS toward the LOM and then the Marshall potential may be separated from the atrial electrogram because the LA may be activated earlier for faster conduction velocity of Bachmann's bundle 15,16 ( Figure 8A). Second, if a histological connection of the MB and LA is present, the activation wavefront may proceed from Bachmann's bundle or the interatrial septum to the LOM through the histological connection 17 (Figure 8B).…”

The Autonomic Nervous System and Atrial Fibrillation: The Roles of Pulmonary Vein Isolation and Ganglionated Plexi Ablation

“…Mehall et al 62 using the same techniques found 14 /15 patient free of AF after a short 6 month follow-up. Matsutani et al 63 reported the results of a combined Japan-United States experience using a "thorascopic mini-Maze" procedure for bilateral PVI plus ablation of the epicardial GP. They found 18 patients (90%) were free of AF over a mean follow-up of 17 months.…”