[Primary experience of treating 23 lone atrial fibrillation patients with a completely thoracoscopic modified Maze procedure].
OBJECTIVE
To evaluate the safety and feasibility of a completely thoracoscopic modified Maze procedure for treatment of patients with lone atrial fibrillation(AF).


METHODS
From September 2010 to October 2011, completely thoracoscopic modified Maze procedure was performed in 23 patients with lone atrial fibrillation (14 paroxysmal AF and 9 persistent AF). All patients were either refractory or intolerant to antiarrhythmic drug therapy or already experienced unsuccessful catheter-based ablation. This procedure includes three 1 cm ports for thoracoscopic camera and ablation device on each side of chest wall. Bilaterally pulmonary vine isolation was made by an Atricure TM bipolar radiofrequency device. Two epicardial ablation lines were created on LAPW to connect bilaterally pulmonary vine ablation lesion using Coolrail linear pen. LAA was removed by a Johnson and Johnson EZ45G stapler.


RESULTS
The procedures were successful in all the patients, 20 patients were in sinus rhythm immediately after surgery, 2 patients were still in AF rhythm and 1 patient in pacing rhythm post surgery. Three-month follow up were finished in 23 patients and there was 1 patient in AF rhythm, 95.7% patients were free of AF; 6-month follow up were finished in 22 patients, 3 patients were in AF rhythm and 2 patients in AFL rhythm, 77.3% patients were free of AF.


CONCLUSIONS
Our results suggested that the completely thoracoscopic modified Maze procedure is a safe, feasible and effective technique for treating patients with atrial fibrillation.
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Yan
Y
Li
Qiu-Ming
QM
Hu
Chun-Lei
CL
Xu
Wen
W
Zeng
Yi-Xin
YX
Jia
Xu
X
Meng
D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013906:Thoracoscopy; D016896:Treatment Outcome