Two-year follow-up of one-stage left unilateral thoracoscopic epicardial and transcatheter endocardial ablation for persistent and long-standing persistent atrial fibrillation

Autor: Carlo de Asmundis, Varnavas Varnavas, Juan Sieira, Erwin Ströker, Henrique E. Coutiño, Muryo Terasawa, Juan Pablo Abugattas, Francesca Salghetti, Riccardo Maj, Osório Thiago Guimarães, Saverio Iacopino, Vincent Umbrain, Jan Poelaert, Pedro Brugada, Sandro Gelsomino, Gian-Battista Chierchia, Mark La Meir
Přispěvatelé: Clinical sciences, Heartrhythmmanagement, Anesthesiology research group, Supporting clinical sciences, Anesthesiology, Cardio-vascular diseases, Cardiac Surgery, Surgical clinical sciences
Rok vydání: 2019
Předmět:
Zdroj: Journal of Interventional Cardiac Electrophysiology. 58:333-343
ISSN: 1572-8595
1383-875X
DOI: 10.1007/s10840-019-00616-w
Popis: PURPOSE: The purpose of this study was to analyze the efficacy and complication rates of a one-stage left unilateral thoracoscopic hybrid procedure in a series of patients with persistent and long-standing persistent atrial fibrillation (AF) in a 2-year follow-up. METHODS: Fifty-one consecutive patients (34 males, 65.7 ± 8 years) having undergone hybrid isolation of pulmonary veins (PVs) and posterior wall of left atrium (LA) by means of left unilateral hybrid thoracoscopic ablation for symptomatic persistent (n = 22, 43%) and long-standing persistent atrial fibrillation (AF) (n = 29, 57%) were analyzed. RESULTS: At a mean follow-up of 24.9 ± 11.8 months (median 24), the success rate without antiarrhythmic therapy was achieved in 68.6% of patients. Procedure-related major complications were observed in 2 patients (4%) including diaphragmatic perforation and late pericardial tamponade requiring mini left-sided thoracotomy and pericardial drainage, respectively. The success rate did not significantly differ between persistent and long-standing persistent AF (respectively, 68.2 and 69%; P = 0.89). Patients with AF relapse during the blanking period were 3.8 times more likely to have AF recurrence after 3 months from the ablation procedure. CONCLUSION: The hybrid one-stage left unilateral thoracoscopic procedure exhibits encouraging results in the setting of both persistent and long-standing persistent AF after a 2-year follow-up, at a low rate of adverse events.
Databáze: OpenAIRE
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