Minimally Invasive Bipolar Radiofrequency Ablation of Lone Atrial Fibrillation: Early Multicenter Results
Erik AK Beyer1, Richard Lee3, B-Khanh Lam2; 1Scott and White Clinic, Temple, TX; 2University of Ottawa Heart Institute, Ottawa, ON, Canada; 3Northwestern University, Chicago, IL
Comment on this Abstract
Objective: With the advent of new technologies, the surgical treatment of lone atrial fibrillation (AF) can be performed via a minimally invasive technique using bipolar radiofrequency ablation. The objectives of this study were to report on the safety and early efficacy of this novel therapeutic modality.
Methods: At three North American institutions between February 2005 and August 2007, 100 patients underwent thoracospic- assisted bilateral pulmonary vein isolation, autonomic denervation and left atrial appendage resection via bilateral mini-thoracotomies. The mean age was 65 +/- 11 years with 70% being male. Median duration of AF was 5.0 years; AF was paroxysmal in 40 (40%) patients, persistent in 29 (29%) and permanent in 31 (31%). Main indications for surgery were failure of medical therapy or percutaneous ablation and severe symptoms. Mean follow-up was 13.6 +/- 8.2 months and 99% complete; all patients had a 24-hour Holter monitor following a blanking period.
Results: The mean operative time was 253 +/- 65 minutes and median hospital length of stay was 5 days. There were no intra-operative conversions. Postoperative complications included pacemaker requirement in 3 (3%) patients, phrenic nerve palsy in 3 (3%), hemothorax in 2 (2%), TIA in 1 (1%) and PE in 1 (1%). There has been no mortality at any time point. At time of follow-up, 87% of patients were in normal sinus rhythm (paroxysmal 93%, persistent 96%, permanent 71%; P<.05); anti-arrhythmic and anticoagulation therapy was discontinued in 62% and 65% of patients respectively.
Conclusion: Minimally invasive bipolar radiofrequency ablation of lone AF is a safe and efficacious therapeutic option in selected patients. Further development is needed to reduce the rate of complication. Long-term prospective results are required to further validate this modality as a therapeutic option to treat lone AF.
Back to 88th Annual Meeting
Back to Program Outline
