title: [Efficacy comparison between video-assisted minimally invasive radiofrequency ablation and catheter ablation in the treatment of persistent atrial fibrillation].
abstract: OBJECTIVE
  To compare the efficacy of the video-assisted minimally invasive radiofrequency ablation in comparison with catheter ablation for the treatment of persistent atrial fibrillation (AF).
  
  
  METHODS
  A total of 172 patients [116 male, mean age (56 ± 12) years] with persistent AF underwent ablation procedures during the last 4 years in our institute (83 patients underwent video-assisted minimally invasive radiofrequency ablation, group MIA and 89 patients underwent circumferential pulmonary vein linear ablation, group CA). Mean duration of preoperative AF was (72 ± 68) months. Patients were follow-uped for a period of 1 to 3.6 years [mean (2.2 ± 0.8) years].
  
  
  RESULTS
  There was no procedure related death. During follow-up, one patient died of encephalorrhagia in CA group, one patient died of sudden death in each group. At the end of the procedure, there were 67 sinus rhythm (39.0%), 4 pacing rhythm (2.3%), 29 atrial flutter or atrial tachycardia (16.9%) and 72 AF (41.9%). Before discharge, sinus rhythm was recorded in 53 patients (63.9%) of MIA group and in 78 patients (87.6%) of CA group; AF recorded in 24 patients (28.9%) of MIA group and in 4 patients (4.5%) of CA group (P < 0.01). At the latest follow-up, sinus rhythm was recorded in 65 patients (79.3%) of MIA group and in 54 patients (62.1%) of CA group; AF or atrial flutter was recorded in 14 patients (17.1%) of MIA group and in 24 patients (27.6%) of CA group (P = 0.028). The Kaplan-Meier survival analysis showed that the long-term efficacy of MIA is superior to CA in terms of incidence of free of AF, AF recurrence and antiarrhythmic drugs (P = 0.03, P = 0.028, P = 0.017, respectively).
  
  
  CONCLUSIONS
  The video-assisted minimally invasive ablation was safe and effective, and had an optimistic long-term success rate for patients with long-lasting persistent AF. Thus, a randomized study comparing the long-term efficacy between the two procedures for patients with long-lasting persistent AF is warranted.
authors.affiliation: Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. wangjiangang7545@126.com
authors.forename: Jian-gang
authors.initials: JG
authors.lastname: Wang
authors.forename: Xu
authors.initials: X
authors.lastname: Meng
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Jie
authors.initials: J
authors.lastname: Han
authors.forename: Chun-lei
authors.initials: CL
authors.lastname: Xu
authors.forename: Yong-qiang
authors.initials: YQ
authors.lastname: Cui
authors.forename: Jian-zeng
authors.initials: JZ
authors.lastname: Dong
authors.forename: Chang-sheng
authors.initials: CS
authors.lastname: Ma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D013906:Thoracoscopy; D016896:Treatment Outcome