Videothoracoscopy for isolated atrial fibrillation ablation through bipolar radiofrequency.
BACKGROUND
The prevalence of atrial fibrillation, expenses with the healthcare system and the associated high morbidity and mortality have justified the search for new therapeutic approaches.


OBJECTIVE
To evaluate the reproducibility of the surgical technique, its safety and the initial outcome of the video-assisted surgery for the isolated atrial fibrillation ablation with bipolar radiofrequency.


METHODS
Ten patients (90% men) with symptomatic atrial fibrillation (50% paroxystic type) that was refractory to drug therapy, with no heart disease that required concomitant surgical treatment, were submitted to arrhythmia ablation guided by thoracoscopy from May 2007 to May 2008. Clinical, laboratory and image variables were prospectively collected before, during surgery and at the postoperative follow-up.


RESULTS
The surgery was carried out as planned in all patients. There was no intra-thoracic structure iatrogenic lesion or deaths. At the mean 6-month follow-up, 80% of the patients were free of atrial fibrillation. There was a significant improvement in the symptoms of New York Heart Association Functional Class heart failure (2.4 + or - 0.5 to 1.6 + or - 0.7; p = 0.011). There was no evidence of pulmonary vein stenosis at the angiotomography in this series.


CONCLUSIONS
The video-assisted surgery for the treatment of atrial fibrillation is reproducible and safe. There is a heart failure symptom evolution improvement after the surgery.
Colafranceschi
Alexandre Siciliano
AS
Instituto Nacional de Cardiologia, Rio de Janeiro, RJ. acolafranceschi@hotmail.com
Monteiro
Andrey José de Oliveira
AJ
Botelho
Eduardo Souza Leal
ES
Canale
Leonardo Secchin
LS
Rabischoffsky
Arnaldo
A
Costa
Ieda Prata
IP
Cruz Filho
Fernando Eugênio dos Santos
FE
Sá
Roberto Luiz Menssing da Silva
RL
Boechat
Ana Luiza
AL
Dallan
Luis Alberto Oliveira
LA
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome