title: Stroke prevention following modified endoscopic ablation and appendectomy for atrial fibrillation.
abstract: We reported the results of stroke prevention following modified endoscopic procedure for atrial fibrillation. 82 patients underwent modified endoscopic procedure for atrial fibrillation (AF), in whom 47 had paroxysmal, 28 had persistent, and 7 had long-standing atrial fibrillation. CHA2DS2VASC median score was 3 (range from 0 to 8). The procedure was performed on the beating heart, through 3 ports on the left chest wall. Pulmonary vein isolation and ablation of the left atrium were achieved by bipolar radiofrequency ablation. Left atrial appendage (LAA) was excluded by stapler. Brain CT, cardiac CT and 24-h Holter monitoring were performed following the procedure. The procedure was successfully completed for all patients. The mean duration was 122 ± 40.1 min. LAA was excluded after appendectomy and checked by intraoperative transesophageal echocardiography. The mean follow-up duration was 24.3 ± 3.5 months. No patients showed signs and symptoms of transient ischemic attack or stroke. No new positive findings were demonstrated by recurring brain CT scan performed after the procedure. Cardiac CT confirmed the absence of LAA and thrombosis in the left atrium. 87.8 % (72/82) of all patients were in sinus rhythm. Our results demonstrate that the modified endoscopic procedure is a safe, effective, and appropriate treatment for AF, which restores sinus rhythm and may be associated with the prevention of AF-related stroke.
authors.affiliation: Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kong Jiang Road, Shanghai, 200092, People's Republic of China.
authors.forename: Nan
authors.initials: N
authors.lastname: Ma
authors.affiliation: Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kong Jiang Road, Shanghai, 200092, People's Republic of China.
authors.forename: Zhaolei
authors.initials: Z
authors.lastname: Jiang
authors.affiliation: Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kong Jiang Road, Shanghai, 200092, People's Republic of China.
authors.forename: Fei
authors.initials: F
authors.lastname: Chen
authors.affiliation: Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kong Jiang Road, Shanghai, 200092, People's Republic of China.
authors.forename: Hang
authors.initials: H
authors.lastname: Yin
authors.affiliation: Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kong Jiang Road, Shanghai, 200092, People's Republic of China.
authors.forename: Fangbao
authors.initials: F
authors.lastname: Ding
authors.affiliation: Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kong Jiang Road, Shanghai, 200092, People's Republic of China. ju_mei63@126.com.
authors.forename: Ju
authors.initials: J
authors.lastname: Mei
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects / Q000379:methods*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020517:Atrial Appendage / Q000503:physiopathology / Q000601:surgery*; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation; D017548:Echocardiography, Transesophageal; D015716:Electrocardiography, Ambulatory; D004724:Endoscopy / Q000009:adverse effects; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Ablation; Atrial fibrillation; Stroke; Surgery