OBJECTIVE: It was our goal to determine the efficacy of a minimally invasive surgical approach to the treatment of atrial fibrillation that combines pulmonary vein antral isolation with targeted partial autonomic denervation. METHODS: Eighty-three patients underwent video-assisted bilateral pulmonary vein antral electrical isolation with confirmation of block and partial autonomic denervation. Sixty-two (41 paroxysmal, 21 persistent/long-standing persistent) patients had a follow-up of 6 months or greater. Fifty-seven of these patients had a long-term rhythm monitor at 6 months (39 paroxysmal, 18 persistent/long-standing persistent). RESULTS: Success was defined as no episodes of atrial fibrillation greater than 15 s duration on long-term monitoring. Treatment was successful in 32 of 39 (82.1%) patients with paroxysmal atrial fibrillation and 10 of 18 (55.6%) with persistent/long-standing persistent atrial fibrillation. CONCLUSION: Early data suggest that pulmonary vein electrical isolation combined with targeted partial autonomic denervation is a safe and efficacious approach for the treatment of paroxysmal atrial fibrillation. Techniques are being developed for the minimally invasive surgical treatment of persistent and long-standing persistent atrial fibrillation from an epicardial approach.
OBJECTIVE: It was our goal to determine the efficacy of a minimally invasive surgical approach to the treatment of atrial fibrillation that combines pulmonary vein antral isolation with targeted partial autonomic denervation. METHODS: Eighty-three patients underwent video-assisted bilateral pulmonary vein antral electrical isolation with confirmation of block and partial autonomic denervation. Sixty-two (41 paroxysmal, 21 persistent/long-standing persistent) patients had a follow-up of 6 months or greater. Fifty-seven of these patients had a long-term rhythm monitor at 6 months (39 paroxysmal, 18 persistent/long-standing persistent). RESULTS: Success was defined as no episodes of atrial fibrillation greater than 15 s duration on long-term monitoring. Treatment was successful in 32 of 39 (82.1%) patients with paroxysmal atrial fibrillation and 10 of 18 (55.6%) with persistent/long-standing persistent atrial fibrillation. CONCLUSION: Early data suggest that pulmonary vein electrical isolation combined with targeted partial autonomic denervation is a safe and efficacious approach for the treatment of paroxysmal atrial fibrillation. Techniques are being developed for the minimally invasive surgical treatment of persistent and long-standing persistent atrial fibrillation from an epicardial approach.
Authors: M A Allessie; P A Boyden; A J Camm; A G Kléber; M J Lab; M J Legato; M R Rosen; P J Schwartz; P M Spooner; D R Van Wagoner ; A L Waldo Journal: Circulation Date: 2001-02-06 Impact factor: 29.690
Authors: Randall K Wolf; E William Schneeberger; Robert Osterday; Doug Miller; Walter Merrill; John B Flege; A Marc Gillinov Journal: J Thorac Cardiovasc Surg Date: 2005-09 Impact factor: 5.209
Authors: Saman Nazarian; Sergey V Kantsevoy; Menekhem M Zviman; Fredrick A Matsen; Hugh Calkins; Ronald D Berger; Henry R Halperin Journal: Heart Rhythm Date: 2008-05-09 Impact factor: 6.343