Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2023, 167(4):362-365 | DOI: 10.5507/bp.2022.041

Thoracoscopic epicardial ablation of atrial fibrillation: Safety, efficacy, single center experience

Martin Troubil, Martin Simek, Jan Juchelka, Andrea Steriovsky, Roman Hajek, Petr Santavy
Department of Cardiac Surgery, University Hospital Olomouc, Czech Republic

Aims: Atrial fibrillation (AF) is associated with reduced quality of life and increased risk of ischaemic cerebrovascular events. The left atrial epicardial ablation procedures have evolved towards a successful and safe rhythm control strategy for patients with symptomatic drug-refractory paroxysmal, persistent or post-ablation AF or with a high risk of catheter ablation failure. The aim was to evaluate the efficacy and safety of thoracoscopic ablation at our instituiton.

Methods: We observed 81 patients undergoing thoracoscopic ablation from January 2015 to December 2019.

Results: The mean age was 61.3±8.5 years and the average duration of AF was 3.1±2.6 years. The cohort consisted of 16.5% of paroxysmal AF, 36.7% persistent, and 46.8% of long-standing AF. The procedure was completed in 79 patients; during follow-up, 15 patients (19%) received radiofrequency ablation. Freedom from atrial arrhythmia recurrence was 55.7% after a follow-up (FUP) period of 3.1±1.4 years. At the follow-up visit, sinus rhythm was present in 81% of patients. No relationships between arrhythmia recurrence and BMI, LVEF, left atrial dimension, gender, and AF duration were found. Major complications were noticed in 4 patients (5.0%); 2 had peripheral embolisation, 2 patients were converted to a sternotomy. At the time of the FUP visit, 25.3% of patients were using antiarrhythmic and 74.7% were still using anticoagulants.

Conclusion: In the majority of patients, sinus rhythm remained despite a considerable atrial tachycardia recurrence rate, with a relatively low percentage of patients on antiarrythmic drugs.

Keywords: atrial fibrillation, thoracoscopic ablation, rhythm

Received: March 13, 2022; Revised: August 25, 2022; Accepted: August 31, 2022; Prepublished online: September 15, 2022; Published: December 4, 2023  Show citation

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Troubil, M., Simek, M., Juchelka, J., Steriovsky, A., Hajek, R., & Santavy, P. (2023). Thoracoscopic epicardial ablation of atrial fibrillation: Safety, efficacy, single center experience. Biomedical papers, 167(4), 362-365. doi: 10.5507/bp.2022.041
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