Gijs E De Maat1, Alberto Pozzoli, Marcoen F Scholten, Hans L Hillege, Isabelle C Van Gelder, Ottavio R Alfieri, Stefano Benussi, Massimo A Mariani. 1. From the *Department of Cardio-Thoracic Surgery, and †Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; ‡Cardiac Surgery Unit, San Raffaele Scientific Institute, Milan, Italy; §Department of Cardiology, Medisch Spectrum Twente, Enschede, The Netherlands; and ∥Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Abstract
OBJECTIVE: Minimally invasive surgical pulmonary vein isolation (SMI-PVI) is an emerging therapy for the treatment of symptomatic drug-refractory atrial fibrillation (AF). Nevertheless, the midterm and long-term results of SMI-PVI remain unknown. The aim of this retrospective multicenter study was to report on midterm efficacy and safety of SMI-PVI. METHODS: The study design was retrospective, multicentric, and observational. From July 2005 to November 2011, a total of 86 patients with drug-refractory paroxysmal or persistent AF underwent SMI-PVI in three centers. Patients were eligible for SMI-PVI if they had symptomatic, drug-refractory AF or after failed transcatheter pulmonary vein isolation. Success was defined as absence of AF on 24- or 96-hour Holter monitoring during follow-up, in the absence of antiarrhythmic drugs (AADs). RESULTS: The mean ± SD age was 54 ± 11 years, and 78% were men. The median AF duration was 30 months (range, 2-203); paroxysmal AF was present in 86% of the patients, persistent in 14%. Fifteen patients (17%) underwent previous transcatheter ablations. After a median follow-up of 24 months (range, 6-78), 72% of all patients were free from atrial arrhythmias without the use of AADs. With AADs, this was 83%. Major perioperative adverse events occurred in 7 patients (8%). CONCLUSIONS: This retrospective multicenter study shows that SMI-PVI is effective at a median follow-up of 24 months for the treatment of mostly paroxysmal drug-refractory AF. Perioperative adverse events do remain a point of caution.
OBJECTIVE: Minimally invasive surgical pulmonary vein isolation (SMI-PVI) is an emerging therapy for the treatment of symptomatic drug-refractory atrial fibrillation (AF). Nevertheless, the midterm and long-term results of SMI-PVI remain unknown. The aim of this retrospective multicenter study was to report on midterm efficacy and safety of SMI-PVI. METHODS: The study design was retrospective, multicentric, and observational. From July 2005 to November 2011, a total of 86 patients with drug-refractory paroxysmal or persistent AF underwent SMI-PVI in three centers. Patients were eligible for SMI-PVI if they had symptomatic, drug-refractory AF or after failed transcatheter pulmonary vein isolation. Success was defined as absence of AF on 24- or 96-hour Holter monitoring during follow-up, in the absence of antiarrhythmic drugs (AADs). RESULTS: The mean ± SD age was 54 ± 11 years, and 78% were men. The median AF duration was 30 months (range, 2-203); paroxysmal AF was present in 86% of the patients, persistent in 14%. Fifteen patients (17%) underwent previous transcatheter ablations. After a median follow-up of 24 months (range, 6-78), 72% of all patients were free from atrial arrhythmias without the use of AADs. With AADs, this was 83%. Major perioperative adverse events occurred in 7 patients (8%). CONCLUSIONS: This retrospective multicenter study shows that SMI-PVI is effective at a median follow-up of 24 months for the treatment of mostly paroxysmal drug-refractory AF. Perioperative adverse events do remain a point of caution.
Authors: Gijs E De Maat; Yoran M Hummel; Alberto Pozzoli; Ottavio R Alfieri; Michiel Rienstra; Yuri Blaauw; Isabelle C Van Gelder; Massimo A Mariani Journal: Biomed Res Int Date: 2018-02-20 Impact factor: 3.411
Authors: Gijs E De Maat; Stefano Benussi; Yoran M Hummel; Sebastien Krul; Alberto Pozzoli; Antoine H G Driessen; Massimo A Mariani; Isabelle C Van Gelder; Wim-Jan Van Boven; Joris R de Groot Journal: Biomed Res Int Date: 2015-07-07 Impact factor: 3.411