A Completely Endoscopic Approach to Microwave Ablation for Atrial Fibrillation

  • Adam E. Saltman
  • Lawrence S. Rosenthal
  • Nicola A. Francalancia
  • Stephen J. Lahey

Abstract

Background: Surgical therapy for atrial fibrillation is extremely effective but not widely applied. Minimally invasive methods may be more attractive. We report a case of complete pulmonary vein isolation performed entirely through a thoracoscopic approach.

Methods: A 74-year-old woman with paroxysmal atrial fibrillation underwent a microwave ablation procedure using 3 access ports in the right pleural space and 3 access ports through the left pleural space.

Results: After the 3-hour procedure the patient was extubated in the operating room and discharged home in sinus rhythm on the second postoperative day.

Conclusions: Endoscopic pulmonary vein isolation is a safe and effective procedure that may be applied to a wide variety of patients.

References

Shah DC, Haissaguerre M, Jais P, et al. 2001. Curative catheter ablation of paroxysmal atrial fibrillation in 200 patients: strategy for presentations ranging from sustained atrial fibrillation to no arrhythmias. Pacing Clin Electrophysiol 24:1541-58.\nSpitzer SG, Richter P, Knaut M, Schuler S. 1999. Treatment of atrial fibrillation in open heart surgery: the potential role of microwave energy. Thorac Cardiovasc Surg 47:374-8.\nWolf PA, Mitchell JB, Baker CS, Kannel WB, D'Agostino RB. 1998. Impact of atrial fibrillation on mortality, stroke, and medical costs. Arch Intern Med 158:229-34.\nGillinov AM, Smedira NG, Cosgrove DM 3rd. 2002. Microwave ablation of atrial fibrillation during mitral valve operations. Ann Thorac Surg 74:1259-61.\nJais P, Hocini M, Macle L, et al. 2002. Distinctive electrophysiological properties of pulmonary veins in patients with atrial fibrillation. Circulation 106:2479-85.\nJais P, Weerasooriya R, Shah DC, et al. 2002. Ablation therapy for atrial fibrillation (AF): past, present and future. Cardiovasc Res 54:337-46.\nKnaut M, Spitzer SG, Karolyi L, et al. 1999. Intraoperative microwave ablation for curative treatment of atrial fibrillation in open heart surgery: the MICRO-STAF and MICRO-PASS pilot trial. MICROwave Application in Surgical treatment of Atrial Fibrillation. MICROwave Application for the Treatment of Atrial Fibrillation in Bypass-Surgery. Thorac Cardiovasc Surg 47:379-84.\nLin JC. 1999. Catheter microwave ablation therapy for cardiac arrhythmias. Bioelectromagnetics Suppl:120-32.\nMaessen JG, Nijs JF, Smeets JL, Vainer J, Mochtar B. 2002. Beating-heart surgical treatment of atrial fibrillation with microwave ablation. Ann Thorac Surg 74:S1307-11.\nPrystowsky EN. 2000. Management of atrial fibrillation: therapeutic options and clinical decisions. Am J Cardiol 85:3D-11D.\nShah DC, Haissaguerre M, Jais P. 2002. Current perspectives on curative catheter ablation of atrial fibrillation. Heart 87:6-8.\n
Published
2005-02-07
How to Cite
Saltman, A. E., Rosenthal, L. S., Francalancia, N. A., & Lahey, S. J. (2005). A Completely Endoscopic Approach to Microwave Ablation for Atrial Fibrillation. The Heart Surgery Forum, 6(3), E38-E41. https://doi.org/10.1532/hsf.956
Section
Articles