title: Minimally invasive surgical versus catheter ablation for the long-lasting persistent atrial fibrillation.
abstract: OBJECTIVE
  To assess the efficacy of video-assisted minimally invasive surgical vs. catheter ablation for the long-standing persistent AF.
  
  
  METHODS
  We performed a retrospective comparative analysis in a series of 166 long-standing persistent AF patients treated between 2006 and 2009 with either video-assisted minimally invasive ablation (83 patients), or catheter ablations (83 patients). The catheter group was screened using a 'pair-matched case-control' methodology in order to select appropriate statistical comparison candidates out of 169 long-standing persistent AF patients which were potentially suitable for surgery, but have been treated with catheter approaches in order to balance major prognostic factors between the two groups. Follow-up for all patients ranged from 1 to 3.6 years.
  
  
  RESULTS
  No patient died postoperatively. One patient suffered from stroke in the surgical group but recovered before discharge. Freedom from AF was obtained in 59.0% and 74.7% during follow-up in the catheter group and the surgical group respectively (P = 0.047). Patients in the catheter group had a significantly higher rate of recurrent arrhythmia (P = 0.011, hazard ratio: 0.555, 95% CI: 0.354 to 0.872) compared with the surgically treated group. The freedom from antiarrhythmic drugs was 44.6% in the catheter group and 61.4% in the surgical group (P = 0.043).
  
  
  CONCLUSIONS
  The video-assisted minimally invasive ablation was safe and effective, and had an optimistic success rate for patients with long-standing persistent AF in our retrospective comparative study. Thus, further randomized studies addressing this issue seem to be justified.
authors.affiliation: Department of Atrial Fibrillation Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Jiangang
authors.initials: J
authors.lastname: Wang
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Jiahai
authors.initials: J
authors.lastname: Shi
authors.forename: Jie
authors.initials: J
authors.lastname: Han
authors.forename: Chunlei
authors.initials: C
authors.lastname: Xu
authors.forename: Changsheng
authors.initials: C
authors.lastname: Ma
authors.forename: Xu
authors.initials: X
authors.lastname: Meng
mesh_terms: D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D012008:Recurrence; D020775:Thoracic Surgery, Video-Assisted; D013997:Time Factors