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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

  • Carlo de AsmundisEmail author
  • Varnavas Varnavas
  • Juan Sieira
  • Erwin Ströker
  • Henrique E. Coutiño
  • Muryo Terasawa
  • Juan Pablo Abugattas
  • Francesca Salghetti
  • Riccardo Maj
  • Osório Thiago Guimarães
  • Saverio Iacopino
  • Vincent Umbrain
  • Jan Poelaert
  • Pedro Brugada
  • Sandro Gelsomino
  • Gian-Battista Chierchia
  • Mark La Meir
Article

Abstract

Purpose

The 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.

Methods

Fifty-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.

Results

At 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.

Conclusion

The 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.

Keywords

Left unilateral hybrid ablation Persistent atrial fibrillation Long-standing persistent atrial fibrillation 

Notes

Compliance with ethical standards

Conflict of interest

CdA receives compensation for teaching purposes and proctoring from AF Solutions, Medtronic, Abbott, Biotronik, and Atricure, and research grants on behalf of the center from Biotronik, Medtronic, St Jude Medical Abbot, Livanova, Boston Scientific, Biosense Webster, Atricure, and CardioTek. GBC receives compensation for teaching purposes and proctoring from AF Solutions and Medtronic. PB receives and speakers fees from Biotronik and Medtronic. MLM is a consultant for Atricure.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Carlo de Asmundis
    • 1
    Email author
  • Varnavas Varnavas
    • 1
  • Juan Sieira
    • 1
  • Erwin Ströker
    • 1
  • Henrique E. Coutiño
    • 1
  • Muryo Terasawa
    • 1
  • Juan Pablo Abugattas
    • 1
  • Francesca Salghetti
    • 1
  • Riccardo Maj
    • 1
  • Osório Thiago Guimarães
    • 1
  • Saverio Iacopino
    • 1
  • Vincent Umbrain
    • 2
  • Jan Poelaert
    • 2
  • Pedro Brugada
    • 1
  • Sandro Gelsomino
    • 3
  • Gian-Battista Chierchia
    • 1
  • Mark La Meir
    • 4
  1. 1.Heart Rhythm Management Centre, Postgraduate course in Cardiac Electrophysiology and Pacing, Vrije Universiteit BrusselUniversitair Ziekenhuis BrusselBrusselsBelgium
  2. 2.Anesthesiology Departement, Vrije Universiteit BrusselUniversitair Ziekenhuis BrusselBrusselsBelgium
  3. 3.Department of Heart and VesselsCareggi HospitalFlorenceItaly
  4. 4.Cardiac Surgery Department, Vrije Universiteit BrusselUniversitair Ziekenhuis Brussel BrusselsBelgium

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