Minimally invasive pulmonary vein isolation and partial autonomic denervation for surgical treatment of atrial fibrillation.

Abstract

OBJECTIVE:

It was our goal to determine the efficacy of a minimally invasive surgical approach to the treatment of atrial fibrillation that combines pulmonary vein antral isolation with targeted partial autonomic denervation.

METHODS:

Eighty-three patients underwent video-assisted bilateral pulmonary vein antral electrical isolation with confirmation of block and partial autonomic denervation. Sixty-two (41 paroxysmal, 21 persistent/long-standing persistent) patients had a follow-up of 6 months or greater. Fifty-seven of these patients had a long-term rhythm monitor at 6 months (39 paroxysmal, 18 persistent/long-standing persistent).

RESULTS:

Success was defined as no episodes of atrial fibrillation greater than 15 s duration on long-term monitoring. Treatment was successful in 32 of 39 (82.1%) patients with paroxysmal atrial fibrillation and 10 of 18 (55.6%) with persistent/long-standing persistent atrial fibrillation.

CONCLUSION:

Early data suggest that pulmonary vein electrical isolation combined with targeted partial autonomic denervation is a safe and efficacious approach for the treatment of paroxysmal atrial fibrillation. Techniques are being developed for the minimally invasive surgical treatment of persistent and long-standing persistent atrial fibrillation from an epicardial approach.

• Authors: James R Edgerton, Warren M Jackman, Michael J Mack
• Journal: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing (J Interv Card Electrophysiol) Vol. 20 Issue 3 Pg. 89-93 (Dec 2007) ISSN: 1572-8595 [Electronic] Netherlands
• PMID: 18165890 (Publication Type: Clinical Trial, Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Atrial Fibrillation (surgery)
• Autonomic Denervation (methods)
• Female
• Heart Conduction System (surgery)
• Humans
• Middle Aged
• Minimally Invasive Surgical Procedures (instrumentation, methods)
• Pulmonary Veins (surgery)
• Thoracoscopes
• Thoracoscopy (methods)
• Treatment Outcome