title: Combined minimally invasive pulmonary vein isolation, left atrial appendage excision and cardiac resynchronization therapy for heart failure: case report.
abstract: A 76-year-old male with ischemic cardiomyopathy presented with heart failure symptoms in the absence of angina. Several hospitalizations were required due to heart failure exacerbation and paroxysmal atrial fibrillation. Electrocardiography and tissue synchronization imaging confirmed ventricular dyssynchrony, requiring biventricular pacing. After a failed attempt of percutaneous placement of the left ventricular lead, a novel minimally invasive approach was indicated. It consisted of left ventricular epicardial lead placement, microwave pulmonary vein isolation, and left atrial appendage excision through bilateral minithoracotomies. The postoperative recovery was unremarkable, with reestablishment of the ventricular synchrony and regular rhythm.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors.forename: Mariano E
authors.initials: ME
authors.lastname: Brizzio
authors.forename: Jose L
authors.initials: JL
authors.lastname: Navia
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Atik
authors.forename: David
authors.initials: D
authors.lastname: Martin
authors.forename: A Marc
authors.initials: AM
authors.lastname: Gillinov
authors.forename: Gonzalo V
authors.initials: GV
authors.lastname: Gonzalez-Stawinski
authors.forename: Bruce
authors.initials: B
authors.lastname: Wilkoff
authors.forename: Randall C
authors.initials: RC
authors.lastname: Starling
mesh_terms: D000368:Aged; D020517:Atrial Appendage / Q000601:surgery*; D001281:Atrial Fibrillation / Q000601:surgery*; D017147:Defibrillators, Implantable; D006333:Heart Failure / Q000601:surgery*; D006801:Humans; D008297:Male; D011667:Pulmonary Veins / Q000601:surgery*; D013908:Thoracotomy / Q000379:methods