BACKGROUND: Atrial fibrillation is the most common form of arrhythmia leading to hospital admission. Over 2.2 million Americans are affected by atrial fibrillation and approximately 160,000 new cases are identified annually. As the population continues to age, the number of patients will increase. AF is an incremental risk factor for death and stroke, and consumes billions of dollars in health care expenditures. METHODS: Between August 2003 and October 2004, 50 drug-resistant, symptomatic atrial fibrillation patients underwent thoracoscopic or robotic-assisted off-pump epicardial microwave ablation with the FLEX 10 device (Guidant, Indianapolis, IN). There were 35 men (70.0%) and 15 women (30.0%), mean age 59.1 years +/- 10.0 (range, 37-75 years). Mean duration of atrial fibrillation was 73.5 months +/- 82.3 (range, 5-480 months). Thirty-three patients (66.0%) had intermittent atrial fibrillation and 17 (34.0%) continuous. Intermittent patients had pulmonary vein isolation whereas continuous patients had additional right and left atrial lesions performed. Forty-six patients (92.0%) had endoscopic stapling of the left atrial appendage. RESULTS: There were no hospital deaths. Postoperative in-hospital complications were minimal with 2 patients (4.0%) experiencing diaphragmatic dysfunction. No patient required a permanent pacemaker implant. Mean postoperative length of stay was 3.7 +/- 2.2 days. Cumulative follow-up was 335.8 patient months, mean 7.6 months (range, 2.0-15.9 months). There was 1 late death (2.0%). In 5 patients (10.0%) the MicroMaze operation and subsequent electrophysiology intervention failed and a Cox-Maze III operation was performed. Follow-up was 100% complete with 79.5% (35 of 44) patients in normal sinus rhythm. CONCLUSIONS: Totally endoscopic closed-chest microwave ablation for treatment of intermittent and continuous atrial fibrillation is technically feasible and presents minimal risk to the patient. Initial results are impressive and demonstrate an enhanced quality of life and freedom from atrial fibrillation in drug-resistant symptomatic patients.
BACKGROUND:Atrial fibrillation is the most common form of arrhythmia leading to hospital admission. Over 2.2 million Americans are affected by atrial fibrillation and approximately 160,000 new cases are identified annually. As the population continues to age, the number of patients will increase. AF is an incremental risk factor for death and stroke, and consumes billions of dollars in health care expenditures. METHODS: Between August 2003 and October 2004, 50 drug-resistant, symptomatic atrial fibrillationpatients underwent thoracoscopic or robotic-assisted off-pump epicardial microwave ablation with the FLEX 10 device (Guidant, Indianapolis, IN). There were 35 men (70.0%) and 15 women (30.0%), mean age 59.1 years +/- 10.0 (range, 37-75 years). Mean duration of atrial fibrillation was 73.5 months +/- 82.3 (range, 5-480 months). Thirty-three patients (66.0%) had intermittent atrial fibrillation and 17 (34.0%) continuous. Intermittent patients had pulmonary vein isolation whereas continuous patients had additional right and left atrial lesions performed. Forty-six patients (92.0%) had endoscopic stapling of the left atrial appendage. RESULTS: There were no hospital deaths. Postoperative in-hospital complications were minimal with 2 patients (4.0%) experiencing diaphragmatic dysfunction. No patient required a permanent pacemaker implant. Mean postoperative length of stay was 3.7 +/- 2.2 days. Cumulative follow-up was 335.8 patient months, mean 7.6 months (range, 2.0-15.9 months). There was 1 late death (2.0%). In 5 patients (10.0%) the MicroMaze operation and subsequent electrophysiology intervention failed and a Cox-Maze III operation was performed. Follow-up was 100% complete with 79.5% (35 of 44) patients in normal sinus rhythm. CONCLUSIONS: Totally endoscopic closed-chest microwave ablation for treatment of intermittent and continuous atrial fibrillation is technically feasible and presents minimal risk to the patient. Initial results are impressive and demonstrate an enhanced quality of life and freedom from atrial fibrillation in drug-resistant symptomatic patients.
Authors: Takeyoshi Ota; Amir Degani; David Schwartzman; Brett Zubiate; Jeremy McGarvey; Howie Choset; Marco A Zenati Journal: Conf Proc IEEE Eng Med Biol Soc Date: 2008
Authors: Hugh Calkins; Karl Heinz Kuck; Riccardo Cappato; Josep Brugada; A John Camm; Shih-Ann Chen; Harry J G Crijns; Ralph J Damiano; D Wyn Davies; John DiMarco; James Edgerton; Kenneth Ellenbogen; Michael D Ezekowitz; David E Haines; Michel Haissaguerre; Gerhard Hindricks; Yoshito Iesaka; Warren Jackman; Jose Jalife; Pierre Jais; Jonathan Kalman; David Keane; Young-Hoon Kim; Paulus Kirchhof; George Klein; Hans Kottkamp; Koichiro Kumagai; Bruce D Lindsay; Moussa Mansour; Francis E Marchlinski; Patrick M McCarthy; J Lluis Mont; Fred Morady; Koonlawee Nademanee; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Douglas L Packer; Carlo Pappone; Eric Prystowsky; Antonio Raviele; Vivek Reddy; Jeremy N Ruskin; Richard J Shemin; Hsuan-Ming Tsao; David Wilber Journal: J Interv Card Electrophysiol Date: 2012-03 Impact factor: 1.900
Authors: Takeyoshi Ota; Nicholas A Patronik; David Schwartzman; Cameron N Riviere; Marco A Zenati Journal: Circulation Date: 2008-09-30 Impact factor: 29.690
Authors: Francisco M Sánchez-Margallo; Idoia Díaz-Güemes; Francisco J Pérez; Miguel A Sánchez; Beatriz Loscertales; Jesús Usón Journal: Surg Endosc Date: 2008-12-05 Impact factor: 4.584