Long‐term outcome after totally thoracoscopic ablation for atrial fibrillation

Vos, Lara M.; Bentala, Mohamed; Geuzebroek, Guillaume S.C.; Molhoek, Sander G.; Putte, Bart P. van

doi:10.1111/jce.14267

Cited by 15 publications

(11 citation statements)

References 21 publications

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“…The ATa-free survival rate of our study showed a similar trend to that of the previous study [8] . It has been hypothesized that direct application of TTA via epicardial access leads to a more constant and uniform transmural lesion.…”

Section: Discussionsupporting

confidence: 89%

Long-term outcome of totally thoracoscopic surgical ablation in atrial fibrillation: A single-center experience

Kwon

Jeong

Park

et al. 2021

IJC Heart & Vasculature

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Background Totally thoracoscopic ablation (TTA) is a minimally invasive and safe alternative to radiofrequency catheter ablation (RFCA) for patients with atrial fibrillation (AF). It has evolved over the last decades, but data are limited. The aim of this study was to report the long-term efficacy and safety of TTA through a single center experience. Methods We retrospectively analyzed all consecutive patients who underwent TTA for AF from February 2012 to December 2018. All patients were followed every 3 months after operation with 12-lead ECG and 24-hour Holter ECG monitoring. The late recurrence of AF was defined as any atrial tachyarrhythmia (ATa) sustained more than 30 s from 3 months after surgery. Results Of the total 408 patients undergoing TTA, 265 were analyzed in this study (17% paroxysmal, persistent or long standing persistent 83%, mean age 56 ± 9 years). During the mean follow-up duration 23 ± 18 months, ATa-free survival rate was 74%, 64%, 58%, 51% and 51% at 1,2,3,4 and 5 years, respectively. At the last follow-up, 75% of patients had sinus rhythm with or without additional intervention. The overall complication rate was 4.5% (12 events) and four patients (1.5%) had a stroke during follow-up. Conclusions TTA could be effective treatment option for AF. It had a very low risk of complication and could reduce stroke incidence. Further studies are needed to improve treatment strategy.

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Section: Discussionsupporting

confidence: 89%

Long-term outcome of totally thoracoscopic surgical ablation in atrial fibrillation: A single-center experience

Kwon

Jeong

Park

et al. 2021

IJC Heart & Vasculature

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“…[22][23][24][25] An observational study found a 60% overall freedom from AF at a mean follow-up of 4.0 AE 0.6 years in a population with normal LV function. 26 A single procedure alone cannot perfectly treat AF. 27 A major advantage of TTA is the achievement and maintenance of PV isolation.…”

Section: Discussionmentioning

confidence: 99%

“… 22 , 23 , 24 , 25 An observational study found a 60% overall freedom from AF at a mean follow-up of 4.0 ± 0.6 years in a population with normal LV function. 26 …”

Section: Discussionmentioning

confidence: 99%

Total thoracoscopic ablation in patients with atrial fibrillation and left ventricular dysfunction

et al. 2021

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Objective: To evaluate the effectiveness and safety of totally thoracoscopic ablation (TTA) in patients with left ventricular (LV) dysfunction for treatment of atrial fibrillation (AF) refractory to antiarrhythmic drug (AAD) therapy.Methods: Between January 2012 and December 2018, 31 patients underwent TTA with drug-refractory AF and preoperative left ventricular ejection fraction (LVEF) <50% were included. Of the 31 patients, 8 received additional catheter ablation with an electrophysiologic study within 3 months after TTA. The rhythm outcome was obtained by 12-lead electrocardiography or 24-hour Holter monitoring. Results:The patient cohort had a mean age of 54.9 AE 9.0 years and consisted of 51.6% with persistent AF (n ¼ 16), 45.2% with long-standing persistent AF (n ¼ 14), and 3.2% with paroxysmal AF (n ¼ 1). No patients died during the follow-up period. Compared with baseline, mean postoperative LVEF at 3 months (interquartile range [IQR], 2-6 months) increased significantly (from 39.7 AE 6.1% to 53.6 AE 9.3%; P < .001). At 25 months (IQR, 14-45 months), LVEF was sustained or further improved (from 39.7 AE 6.1% to 58.1 AE 7.5%; P < .001). The rate of sinus rhythm state was 93.5% (29 of 31), and freedom from arrhythmias off AADs after the final procedure was 61.3% (19 of 31) at a median follow-up of 32 months (IQR, 24-54 months).

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“…The one patient with recurrent atrial fibrillation refused to submit to the follow-up catheter study and potential ablation. Moreover, van Putte’s group recently reported an overall freedom from atrial arrhythmias in 82 patients undergoing only the thoracoscopic procedure of 60% after a mean follow-up of 4.0 + 0.3 years [ 85 ].…”

Section: Current Status Of Surgical Ablation For Stand-alone Afmentioning

confidence: 99%

Surgery and Catheter Ablation for Atrial Fibrillation: History, Current Practice, and Future Directions

McCarthy

Cox

Kislitsina

et al. 2021

JCM

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Atrial fibrillation (AF) is the most common of all cardiac arrhythmias, affecting roughly 1% of the general population in the Western world. The incidence of AF is predicted to double by 2050. Most patients with AF are treated with oral medications and only approximately 4% of AF patients are treated with interventional techniques, including catheter ablation and surgical ablation. The increasing prevalence and the morbidity/mortality associated with AF warrants a more aggressive approach to its treatment. It is the purpose of this invited editorial to describe the past, present, and anticipated future directions of the interventional therapy of AF, and to crystallize the problems that remain.

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Long‐term outcome after totally thoracoscopic ablation for atrial fibrillation

Cited by 15 publications

References 21 publications

Long-term outcome of totally thoracoscopic surgical ablation in atrial fibrillation: A single-center experience

Long-term outcome of totally thoracoscopic surgical ablation in atrial fibrillation: A single-center experience

Total thoracoscopic ablation in patients with atrial fibrillation and left ventricular dysfunction

Surgery and Catheter Ablation for Atrial Fibrillation: History, Current Practice, and Future Directions

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