title: Surgical treatment of lone atrial fibrillation in an awake patient.
abstract: Surgical treatment of atrial fibrillation recently gained new popularity since the introduction of different energy sources and the development of minimally invasive techniques as an alternative to the original "cut-and-sew" technique. However, closed-chest ablation procedures are not feasible in presence of pericardial or pleural adhesions. To our knowledge, this is the first report of surgical treatment of atrial fibrillation in a conscious patient by means of a high epidural anesthesia. Since evidence of fibrothorax was found, a conscious patient suffering from lone atrial fibrillation underwent a beating-heart pulmonary veins isolation with a microwave device through a standard sternotomic approach. At 6 months follow-up, the patient is in stable sinus rhythm, without any palpitation nor electrocardiographic evidence (Holter monitoring) of recurrent atrial fibrillation.
authors.affiliation: Division of Cardiac Surgery, University of Brescia Medical School, Brescia, Italy. gianluigi_bisleri@katamail.com
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Bisleri
authors.forename: Tomaso
authors.initials: T
authors.lastname: Bottio
authors.forename: Aldo
authors.initials: A
authors.lastname: Manzato
authors.forename: Claudio
authors.initials: C
authors.lastname: Muneretto
mesh_terms: D000368:Aged; D000767:Anesthesia, Epidural; D001281:Atrial Fibrillation / Q000150:complications* / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation; D004867:Equipment Design; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008872:Microwaves / Q000627:therapeutic use; D009200:Myocardial Contraction; D010496:Pericardium; D010995:Pleural Diseases / Q000150:complications*; D011667:Pulmonary Veins / Q000601:surgery; D000267:Tissue Adhesions; D016896:Treatment Outcome; D014851:Wakefulness