Minimally invasive epicardial ablation of lone atrial fibrillation in pediatric patient.
We describe a case of epicardial surgical ablation of drug refractory lone atrial fibrillation in a pediatric patient. Minimally invasive radiofrequency equipment was used off-pump through a right mini-thoracotomy. Electrical isolation of the pulmonary veins cuffs was obtained. The preoperative electrophysiological study identified a macro re-entrant circuit around the pulmonary veins orifices as the mechanism of arrhythmia triggering. At follow-up, the patient is in stable sinus rhythm and there is no evidence of pulmonary vein stenosis. The minimally invasive, off-pump ablation of lone atrial fibrillation is feasible and reliable, even in children who may pose incremental technical challenges. This technique may represent an additional tool for the current treatment algorithms to treat lone atrial fibrillation.
Nasso
Giuseppe
G
Department of Cardiac Surgery, Anthea Hospital, GVM Hospitals of Care and Research, Bari, Italy. gnasso@libero.it
Bonifazi
Raffaele
R
Fiore
Flavio
F
Balducci
Giuseppe
G
Conte
Massimiliano
M
Lopriore
Vincenzo
V
Speziale
Giuseppe
G
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D002648:Child; D022062:Electrophysiologic Techniques, Cardiac; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D011667:Pulmonary Veins / Q000601:surgery*; D013908:Thoracotomy; D017211:Treatment Failure; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents