title: Minimally invasive epicardial left atrial ablation and appendectomy for refractory atrial tachycardia.
abstract: Surgical removal or epicardial radiofrequency ablation of the left atrial appendage (LAA) is occasionally required when endocardial ablations fail. We report a modified minimally invasive surgical approach for elimination of recurrent atrial arrhythmias arising from the LAA, including both radiofrequency ablation and appendectomy. Ablation of the LAA base was performed using the Medtronic Cardioblate bipolar radiofrequency device (Medtronic, Minneapolis, MN), and left atrial appendectomy was then completed using the EndoGIA stapling system (US Surgical, Norwalk, CT). This procedure successfully isolated and removed the tachycardia focus, and normal sinus rhythm was restored. Elimination of LAA arrhythmias using a combination of epicardial radiofrequency ablation and appendectomy ensures electrical isolation while minimizing surgical invasiveness.
authors.affiliation: Division of Cardiac Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
authors.forename: Jeremy R
authors.initials: JR
authors.lastname: McGarvey
authors.forename: David
authors.initials: D
authors.lastname: Schwartzman
authors.forename: Takeyoshi
authors.initials: T
authors.lastname: Ota
authors.forename: Marco A
authors.initials: MA
authors.lastname: Zenati
mesh_terms: D020517:Atrial Appendage / Q000503:physiopathology / Q000601:surgery*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D003131:Combined Modality Therapy; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D013617:Tachycardia, Supraventricular / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome