title: Complete thoracoscopic ablation of the left atrium via the left chest for treatment of lone atrial fibrillation.
abstract: OBJECTIVE
  We developed a new thoracoscopic ablation procedure for lone atrial fibrillation (AF) based on new endoscopic technology and the adoption of new types of energy.
  
  
  METHODS
  Fifty-five patients with lone atrial fibrillation underwent this therapy. Patient age ranged from 30 to 81 years and there were 39 men and 16 women. Of these patients, 38 had paroxysmal atrial fibrillation, 14 had persistent atrial fibrillation, and 3 had longstanding atrial fibrillation. The procedure was performed on the beating heart through 3 ports in the left chest wall. Pulmonary vein isolation and ablation of the left atrium were achieved by bipolar radiofrequency ablation. Ganglionic plexus ablation was completed using the ablation pen. The left atrial appendage was excluded.
  
  
  RESULTS
  Mean procedure duration was 106.6 ± 42.8 minutes. No conversion to sternotomy or pacemaker implantation occurred and no patients died. Their hospital stay was 5.3 ± 2.0 days with a mean follow-up of 12.6 ± 2.2 months. Forty-nine of 55 patients (89.1%) patients were in sinus rhythm. Six patients could not maintain sinus rhythm. Thrombus in the left atrium and stenosis of the pulmonary vein were not found postoperatively.
  
  
  CONCLUSIONS
  This less invasive procedure proved to be safe and presented optimistic outcomes, so it deserves to be promoted as a treatment for lone atrial fibrillation.
authors.affiliation: Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China. Electronic address: ju_mei@yahoo.cn.
authors.forename: Ju
authors.initials: J
authors.lastname: Mei
authors.affiliation: Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China.
authors.forename: Nan
authors.initials: N
authors.lastname: Ma
authors.affiliation: Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China.
authors.forename: Fangbao
authors.initials: F
authors.lastname: Ding
authors.affiliation: Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China.
authors.forename: Yin
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China.
authors.forename: Zhaolei
authors.initials: Z
authors.lastname: Jiang
authors.affiliation: Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China.
authors.forename: Fengqing
authors.initials: F
authors.lastname: Hu
authors.affiliation: Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China.
authors.forename: Haibo
authors.initials: H
authors.lastname: Xiao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020517:Atrial Appendage / Q000503:physiopathology / Q000601:surgery; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005725:Ganglia, Autonomic / Q000503:physiopathology / Q000601:surgery; D006325:Heart Atria / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery; D013906:Thoracoscopy / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
keywords: 24; 28; AF; GP; PVI; atrial fibrillation; ganglionic plexus; pulmonary vein isolation