Minimally invasive surgical ablation of atrial fibrillation: Six-month results

Edgerton, James R.; McClelland, James H.; Duke, David J.; Gerdisch, Marc W.; Steinberg, Bettie M.; Bronleewe, Scott H.; Prince, Syma L.; Herbert, Morley A.; Hoffman, Shannon

doi:10.1016/j.jtcvs.2008.09.080

Cited by 82 publications

(61 citation statements)

References 25 publications

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“…A second, larger report from this group in 114 patients reported that 72%, 46.9%, and 32% of patients with paroxysmal, persistent, and long-standing persistent AF, respectively, were free of AF and off antiarrhythmic medications at 195 days of follow-up. 1355 Another multi-center series of 100 patients with a similar approach and mean follow-up of 13.6 months reported a sinus restoration rate of 87%, with 64% of patients free from AADs. 1356 The results of these and other trials cited earlier in this section have made it clear that a more extensive lesion set than PVI alone is required for successful surgical treatment of persistent and long-standing persistent AF.…”

Section: Stand-alone Surgical Ablation Of Afmentioning

confidence: 98%

“…197,1369,1370,1371 However, investigators showed that this treatment was inadequate for patients with persistent and long-standing persistent AF. 1355 This led to the belief that the persistent forms of AF needed both substrate modification and trigger isolation , and this provided the impetus to develop the Dallas lesion set, which replicated all the LA lesions of the Cox-Maze III, yet allowed them to be placed on the surface of the full-beating LA. Although it was a major step forward, with a success rate of 79%, this approach failed to reach the success rates of the Cox-Maze III.…”

Section: Stand-alone Surgical Ablation Of Afmentioning

confidence: 99%

See 1 more Smart Citation

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

1,769

1,468

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Section: Stand-alone Surgical Ablation Of Afmentioning

confidence: 98%

Section: Stand-alone Surgical Ablation Of Afmentioning

confidence: 99%

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

1,769

1,468

View full text Add to dashboard Cite

“…Another study with 114 patients published that 46.9% and 32% of patients with persistent and longstanding persistent AF were free of AF and off antiarrhythmic medications at 195 days of follow-up [22]. After thoracoscopic offpump radiofrequency pulmonary vein isolation plus left atrial appendage exclusion 60% to 80% of patients obtain sinus rhythm [23][24][25][26].…”

Section: Thoracoscopic Epicardial Posterior Left Atrial Wall Isolatiomentioning

confidence: 99%

Minimally invasive epicardial posterior left atrial wall isolation: technique and results

Floria¹,

Grecu²,

Tinică³

2017

Arch Clin Cases

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Atrial fibrillation (AF) is the most frequent arrhythmia in clinical practice. Catheter and surgical ablation has emerged as an alternative to maintain sinus rhythm and to avoid long-term AF complications. An ablation technique aims to target the triggers and the substrate of AF to prevent initiation and perpetuation of this arrhythmia. Surgical ablation is the gold standard in AF ablation; it has the best results in maintaining sinus rhythm in patients with persistent AF. Epicardial posterior left atrial wall isolation by right monolateral thoracoscopic approach is a minim invasive surgical technique that aims to eliminate major ganglionated plexi isolation influence on atrial myocardium in addition to pulmonary vein isolation. The exclusion of the left atrial posterior wall, including the pulmonary veins (considered as triggers or initiators) could be completed with an additional isolation/destruction of the adjacent major ganglionated plexi (considered as substrate modifiers) including the complex interconnection neural network which could add to influence the persistence of AF. Different hybrid surgical ablation lesions sets were developed, usually in a manner less than the full Cox-Maze IV lesion set. They are performed epicardially via minimally invasive (non-sternotomy) approaches without cardiopulmonary bypass, followed by catheter-based endocardial mapping, and if necessary additional ablation lines. The results of these innovative techniques are promising in persistent and long persistent AF. Epicardial right monolateral thoracoscopic approach to isolate the pulmonary vein and the major ganglionated plexi isolation in symptomatic refractory persistent AF patients is feasible and efficient.

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“…Durch Einsatz des neuen, rein thorakoskopischen bipolaren Ablationsverfahrens gelingt eine Substratmodifikation des linken Vorhofs mit zusätzlicher Entfernung des linken Vorhofohrs [32,33]. Mittels Einbringen von jeweils 3 Ports in beide Thoraxhälften und Insufflation von CO 2 können nach Eröffnen des Perikards beide Pulmonalvenenpaare, durch Herstellen einer "box lesion" das Antrum des linken Vorhofs und durch eine lineare Ablationslinie im Bereich des linken Vorhofdachs der linksatriale Isthmus abladiert werden (.…”

Section: Bipolare Hochfrequenzenergieunclassified

Rhythmuschirurgie des Vorhofflimmerns und postoperatives Monitoring

Hanke

Sievers

2011

Herz

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Atrial fibrillation represents the most common atrial arrhythmia seen in clinical practice. The surgical treatment of atrial fibrillation is recommended in symptomatic patients as well as in asymptomatic patients at low postoperative risk. As a "stand alone" procedure, surgical ablation therapy is indicated after failed catheter ablation therapy, which occurs increasingly due to the high number of catheter-based ablation techniques. In order to gain acceptance among patients as well as referring cardiologists, the surgical ablation procedure ought to be performed in a minimally invasive fashion and with a very high success rate. When applied in an interdisciplinary approach by cardiologists/electrophysiologists and cardiothoracic surgeons, both ablative techniques have the potential to treat atrial fibrillation effectively and in the long-term. In order to document the true heart rhythm after ablation therapy, intermittent "snapshot" ECG documentation ought to be avoided. Small leadless devices that can be implanted subcutaneously enable full heart rhythm disclosure with documentation of atrial arrhythmias. The modern technique of implantable loop recorders permits individualized treatment for each patient.

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Minimally invasive surgical ablation of atrial fibrillation: Six-month results

Cited by 82 publications

References 25 publications

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Minimally invasive epicardial posterior left atrial wall isolation: technique and results

Rhythmuschirurgie des Vorhofflimmerns und postoperatives Monitoring

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