Abstract 3319: Minimally Invasive Atrial Fibrillation Surgery: Six-Month Results
PURPOSE A minimally invasive surgical approach to the treatment of atrial fibrillation (AF) has been developed with bilateral pulmonary vein isolation, mapping and ablation of the ganglionic plexi and excision of the left atrial appendage.
METHODS The procedure is performed through bilateral minithoracotomies with video assistance. Bilateral separate pulmonary vein isolation is performed with bipolar radiofrequency and location of ganglionic plexi is determined by high frequency stimulation and appropriately ablated. The left atrial appendage is excluded or excised. Clinical follow up was at 1,3, and 6 months with EKG, 24-hour Holter monitor and/or 7-day event monitoring/pacemaker interrogation.
RESULTS 47 patients, 35(74.5%) with paroxysmal, and 12 (25.5%) with permanent AF underwent the procedure. All procedures were successfully accomplished without conversion. There was 1 (2.1%) operative mortality, 1 (2.1%) clotted hemothorax, and 1 (2.1%) transient brachial plexus palsy. 6-month clinical and EKG follow up is complete on the first 26 patients with overall success rate 92.3%. (Table⇓) 21 (80.7%) had event monitoring with a success rate (no AF > 3 seconds) of 85.7%. CONCLUSIONS Minimally invasive atrial fibrillation surgery is highly effective treatment of paroxysmal AF at six months. A more extensive lesion set may be necessary for permanent AF.