[Thoracoscopy video assisted minimally invasive bilateral pulmonary vein isolation for treatment of atrial fibrillation].
OBJECTIVE
This study is to evaluate the feasibility and safety of thoracoscopy video assisted minimally invasive bilateral pulmonary vein isolation for treatment of atrial fibrillation.


METHODS
From December 2006 to April 2007, thorascopy video assisted off-pump epicardial pulmonary vein isolation was performed in 20 patients with atrial fibrillation. All patients were either refractory or intolerant to antiarrhythmic drug therapy or already experienced unsuccessful catheter-based ablation. The procedure includes 21 cm ports for the thoracoscopic camera and ablation device, and a 5 cm working port on each side of the chest wall. Bilaterally pulmonary vine were isolated by using an stricure(TM) bipolar radiofrequency device. LAA was removed by using a Johnson & Johnson EZ45G stapler. Intraoperative pacing and sensing was used to confirm bidirectional block of the ablation lines.


RESULTS
The procedure was successful in all patients. Nineteen patients were in sinus rhythm immediately after the surgery and 1 patient was still in AF rhythm post surgery and converted to sinus rhythm by electrical conversion in the operation room. One patient was reintubated because of low SaO2 and 1 patient received IABP for LV failure. Mean operation time was (130 +/- 25) min and average hospital stay was (8.0 +/- 3.8) d. 3-months follow up was finished in 12 patients at after the surgery and 10 patients were free of AF (10/12, 83.3%), 6-months follow up was finished in 3 patients and all in sinus rhythm (3/3, 100%).


CONCLUSIONS
Our results suggested that thoracoscopy video assisted minimally invasive bilateral pulmonary vein isolation is a safe, feasible and effective technique for treatment of atrial fibrillation.
Li
Yan
Y
Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China.
Cui
Yong-qiang
YQ
Xu
Chun-lei
CL
Gao
Feng
F
Li
Hui
H
Zhang
Hai-bo
HB
Han
Jie
J
Wang
Jian-gang
JG
Meng
Xu
X
D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*