Safety and efficacy of thoracoscopic ablation in the treatment of patients with isolated atrial fibrillation
Abstract
Objective of the study. To evaluate the safety profile and efficiency of thoracoscopic ablation in the treatment of patients with isolated atrial fibrillation.
Materials and methods. The study included the treatment data of 78 patients (61 men and 17 women) who underwent thoracoscopic ablation and left atrial auricle amputation for the treatment of AF. The mean age of the patients was 58.0±8.5 years. Long-existing form of AF was presented in 87,2%, expressed LV dysfunction in 21,8% of patients. The study evaluated the efficacy and incidence of complications that occurred during the operation and during 30 days postoperative period.
Results. No deaths, access conversions, cerebrovascular events, or bleeding were recorded in the study group of patients during the entire follow-up period. Freedom from all types of complications was 86% during the 30-day follow-up period. The most frequent complication of the postoperative period was respiratory tract infections, recorded in 10.3% of cases. By the time of discharge from the hospital, sinus rhythm was registered in 79.4% of patients.
Conclusion. The application of thoracoscopic ablation and isolation of the LA appendage in an experienced cardiosurgical centre is a safe and effective technique of treatment of patients with isolated AF.
About the Authors
O. Yu. Pidanov
State Clinical Hospital named after I.V.Davydovsky, MHD
Russian Federation
Russian Federation
K. V. Shcherbatyuk
State Clinical Hospital named after I.V.Davydovsky, MHD
Russian Federation
Russian Federation
D. N. Kuzmin
State Clinical Hospital named after I.V.Davydovsky, MHD
Russian Federation
Russian Federation
References
1. Zhang J, Johnsen SP, Guo Y, Lip GYH. Epidemiology of Atrial Fibrillation: Geographic/ Ecological Risk Factors, Age, Sex, Genetics. Card Electrophysiol Clin. 2021 Mar;13(1):1-23. doi: 10.1016/j.ccep.2020.10.010. Epub 2021 Jan 8. PMID: 33516388.
2. Kotalczyk A, Lip GY, Calkins H. The 2020 ESC Guidelines on the Diagnosis and Management of Atrial Fibrillation. Arrhythm Electrophysiol Rev. 2021 Jul;10(2):65-67. doi: 10.15420/aer.2021.07. PMID: 34401177; PMCID: PMC8335854.
3. Tilz RR, Rillig A, Thum AM, Arya A, Wohlmuth P, Metzner A, Mathew S, Yoshiga Y, Wissner E, Kuck KH, Ouyang F. Catheter ablation of long-standing persistent atrial fibrillation: 5-year outcomes of the Hamburg Sequential Ablation Strategy. J Am Coll Cardiol. 2012 Nov 6;60(19):1921-9. doi:
4. Straube F, Pongratz J, Kosmalla A, Brueck B, Riess L, Hartl S, Tesche C, Ebersberger U, Wankerl M, Dorwarth U, Hoffmann E. Cryoballoon Ablation Strategy in Persistent Atrial Fibrillation. Front Cardiovasc Med. 2021 Nov 18;8:758408. doi: 10.3389/fcvm.2021.758408. PMID: 34869671; PMCID: PMC8636924.
5. van Laar C, Bentala M, Weimar T, Doll N, Swaans MJ, Molhoek SG, Hofman FN, Kelder J, van Putte BP. Thoracoscopic ablation for the treatment of atrial fibrillation: a systematic outcome analysis of a multicentre cohort. Europace. 2019 Jun 1;21(6):893-899. doi: 10.1093/europace/euy323. PMID: 30689852.
6. Harlaar N, Oudeman MA, Trines SA, de Ruiter GS, Mertens BJ, Khan M, Klautz RJM, Zeppenfeld K, Tjon A, Braun J, van Brakel TJ. Long-term follow-up of thoracoscopic ablation in long-standing persistent atrial fibrillation. Interact Cardiovasc Thorac Surg. 2022 Jun 1;34(6):990-998. doi: 10.1093/icvts/ivab355. PMID: 34957518; PMCID: PMC9159446.
7. Varzaly JA, Lau DH, Chapman D, Edwards J, Worthington M, Sanders P. Hybrid ablation for atrial fibrillation: A systematic review and metaanalysis. JTCVS Open. 2021 Jul 16;7:141-154. doi: 10.1016/j.xjon.2021.07.005. PMID: 36003726; PMCID: PMC9390199.
8. Edgerton JR, Philpot LM, Falley B, Barnes SA. Totally Thoracoscopic Surgical Ablation or Catheter Ablation of Atrial Fibrillation: A Systematic Review and Preliminary Meta-Analysis. Card Electrophysiol Clin. 2012 Sep;4(3):413-23. doi: 10.1016/j.ccep.2012.05.001. PMID: 26939961.
9. Boersma LV, Castella M, van Boven W, Berruezo A, Yilmaz A, Nadal M et al. Atrial fibrillation catheter ablation versus surgical ablation treatment (FAST): a 2- center randomized clinical trial. Circulation 2012;125:23–30.
10. Пиданов О.Ю., Богачев-Прокофьев А.В., Елесин Д.А., Иваницкий Э.А., Бобровский О.А., Шиленко П.А., Дурыгин П.А., Зотов А.С., Вачев C.А., Вайкин В.Е., Мамчур С.Е., Сапельников О.В., Быстров Д.О. Торакоскопическая аблация для лечения пациентов с изолированной формой фибрилляции предсердий в России. Патология кровообращения и кардиохирургия. 2018;22(2):14-21. http://dx.doi.org/10.21688/1681-3472-2018-2-14-21
11. Пиданов О.Ю., Зотов А.С. Торакоскопическая хирургия фибрилляции предсердий. – М. ООО «Ваш формат», 2020, – Г. 5-6. – С. 73-110.
12. Vos LM, Kotecha D, Geuzebroek GSC, Hofman FN, van Boven WJP, Kelder J, de Mol BAJM, van Putte BP. Totally thoracoscopic ablation for atrial fibrillation: a systematic safety analysis. Europace. 2018 Nov 1;20(11):1790-1797. doi: 10.1093/europace/eux385. PMID: 29361045; PMCID: PMC6212776.
13. Пиданов О.Ю., Цепенщиков В.А, Щербатюк К.В.,Аврусина Е.К., Коломейченко Н.А., Рослякова И.О. Торакосокпическая абляция в лечении пациентов с изолированной формой фибрилляции предсердий. Анналы аритмологии, 2017; 14(4): 190- 198. DOI: 10.15275/annaritmol.2017.4.2
14. Yin-jun Mao, Hang Wang, Jian-xing Chen, Pinfang Huang. Meta-analysis of medical management versus catheter ablation for atrial fibrillation. Rev. Cardiovasc. Med. 2020, 21(3), 419–432.https://doi.org/10.31083/j.rcm.2020.03.60
15. Natale A, Mohanty S, Goldstein L, Gomez T, Hunter TD. Real-world safety of catheter ablation for atrial fibrillation with contact force or cryoballoon ablation. J Interv Card Electrophysiol. 2021 Apr;60(3):445-452. doi: 10.1007/s10840-020-00734-w. Epub 2020 May 11. PMID: 32390061; PMCID: PMC8134302
16. van Laar C, Verberkmoes NJ, van Es HW, Lewalter T, Dunnington G, Stark S, Longoria J, Hofman FH, Pierce CM, Kotecha D, van Putte BP. Thoracoscopic Left Atrial Appendage Clipping: A Multicenter Cohort Analysis. JACC Clin Electrophysiol. 2018 Jul;4(7):893- 901. doi: 10.1016/j.jacep.2018.03.009. Epub 2018 May 2. PMID: 30025689.
17. Kim JY, Jeong DS, Park SJ, Park KM, Kim JS, On YK. Long-Term Efficacy and Anticoagulation Strategy of Left Atrial Appendage Occlusion During Total Thoracoscopic Ablation of Atrial Fibrillation to Prevent Ischemic Stroke. Front Cardiovasc Med. 2022 Mar 31;9:853299. doi: 10.3389/fcvm.2022.853299. PMID: 35433859; PMCID: PMC9008268.
Review
For citations:
Pidanov O.Yu., Shcherbatyuk K.V., Kuzmin D.N. Safety and efficacy of thoracoscopic ablation in the treatment of patients with isolated atrial fibrillation. Minimally Invasive Cardiovascular Surgery. 2024;3(2):11-17. (In Russ.)
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