Surgical treatment of lone atrial fibrillation in an awake patient.
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.
Bisleri
Gianluigi
G
Division of Cardiac Surgery, University of Brescia Medical School, Brescia, Italy. gianluigi_bisleri@katamail.com
Bottio
Tomaso
T
Manzato
Aldo
A
Muneretto
Claudio
C
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