title: Hybrid thoracoscopic epicardial and catheter-based endocardial ablation for atrial fibrillation.
abstract: Treatment of atrial fibrillation (AF) has evolved substantially, from open surgical 'cut-and-sew' procedures to catheter ablations to minimally invasive ablation with novel energy sources. Recurrences present a significant challenge, both to clinicians and to patients who seek a durable result and freedom from antiarrhythmic medications. Our centre performs a minimally invasive bilateral thoracoscopic epicardial ablation and atrial appendage exclusion, followed by a catheter-based endocardial electrophysiology study and ablation. Results demonstrate favourable outcomes with improvement over catheter-based ablation alone or thoracoscopic ablation alone. We will describe our surgical approach, mid-term results and a brief review of the literature surrounding this dual-modality approach to AF ablation.
authors.affiliation: Department of Surgery, Division of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville, VA, USA.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Downs
authors.affiliation: Department of Surgery, Division of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville, VA, USA gorav@virginia.edu.
authors.forename: Gorav
authors.initials: G
authors.lastname: Ailawadi
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods; D004699:Endocardium / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D013906:Thoracoscopy / Q000379:methods*; D016896:Treatment Outcome
keywords: Ablation techniques; Atrial fibrillation; Thoracoscopic surgery