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Two-year follow-up of one-stage left unilateral thoracoscopic epicardial and transcatheter endocardial ablation for persistent and long-standing persistent atrial fibrillation

Authors
  • de Asmundis, Carlo1
  • Varnavas, Varnavas1
  • Sieira, Juan1
  • Ströker, Erwin1
  • Coutiño, Henrique E.1
  • Terasawa, Muryo1
  • Abugattas, Juan Pablo1
  • Salghetti, Francesca1
  • Maj, Riccardo1
  • Guimarães, Osório Thiago1
  • Iacopino, Saverio1
  • Umbrain, Vincent2
  • Poelaert, Jan2
  • Brugada, Pedro1
  • Gelsomino, Sandro3
  • Chierchia, Gian-Battista1
  • La Meir, Mark2
  • 1 Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussels, 1090, Belgium , Brussels (Belgium)
  • 2 Universitair Ziekenhuis Brussel, Brussels, Belgium , Brussels (Belgium)
  • 3 Careggi Hospital, Florence, Italy , Florence (Italy)
Type
Published Article
Journal
Journal of Interventional Cardiac Electrophysiology
Publisher
Springer-Verlag
Publication Date
Sep 13, 2019
Volume
58
Issue
3
Pages
333–343
Identifiers
DOI: 10.1007/s10840-019-00616-w
Source
Springer Nature
Keywords
License
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Abstract

PurposeThe purpose of this study was to analyze the efficacy and complication rates of a one-stage left unilateral thoracoscopic hybrid procedure in a series of patients with persistent and long-standing persistent atrial fibrillation (AF) in a 2-year follow-up.MethodsFifty-one consecutive patients (34 males, 65.7 ± 8 years) having undergone hybrid isolation of pulmonary veins (PVs) and posterior wall of left atrium (LA) by means of left unilateral hybrid thoracoscopic ablation for symptomatic persistent (n = 22, 43%) and long-standing persistent atrial fibrillation (AF) (n = 29, 57%) were analyzed.ResultsAt a mean follow-up of 24.9 ± 11.8 months (median 24), the success rate without antiarrhythmic therapy was achieved in 68.6% of patients. Procedure-related major complications were observed in 2 patients (4%) including diaphragmatic perforation and late pericardial tamponade requiring mini left-sided thoracotomy and pericardial drainage, respectively. The success rate did not significantly differ between persistent and long-standing persistent AF (respectively, 68.2 and 69%; P = 0.89). Patients with AF relapse during the blanking period were 3.8 times more likely to have AF recurrence after 3 months from the ablation procedure.ConclusionThe hybrid one-stage left unilateral thoracoscopic procedure exhibits encouraging results in the setting of both persistent and long-standing persistent AF after a 2-year follow-up, at a low rate of adverse events.

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