Surgical Ablation of “Lone” Atrial Fibrillation—A Systematic Review of the Literature

2014 ◽  
Vol 23 (1) ◽  
pp. e60-e61
Author(s):  
J.A. Varzaly ◽  
A. Brooks ◽  
J. Edwards ◽  
R.G. Stuklis ◽  
P. Sanders ◽  
...  
2017 ◽  
Vol 26 ◽  
pp. S384
Author(s):  
Satyanarayan Shanbhag ◽  
Alireza Kashani ◽  
Yuvaraj Davidson ◽  
Parma Nand ◽  
Indran Ramanathan

Author(s):  
John R. Doty ◽  
Stephen E. Clayson

Objective Surgical ablation with radiofrequency is a safe and effective treatment for atrial fibrillation. Recent advances in instrumentation have allowed for the application of bipolar radiofrequency through a minimally invasive approach using small bilateral thoracotomies for pulmonary vein isolation, destruction of autonomic ganglia, and excision of the left atrial appendage (GALAXY procedure). Methods Thirty-two patients underwent surgical ablation of atrial fibrillation with the GALAXY procedure over a 43-month period. Data were collected in a prospective manner during hospitalization and at 1-, 3-, 6-, and 12-month intervals for rhythm, medications, and subsequent interventions. Results There were no operative mortality, no myocardial infarction, and no stroke. One patient required reexploration for bleeding. Mean follow-up was 28 months (range, 4–43 months). Freedom from atrial fibrillation at 12 and 24 months, respectively, was 90% and 67% for patients with paroxysmal fibrillation and 80% and 63% for patients with persistent atrial fibrillation. Of the patients who were not in sinus rhythm, four reverted to atrial fibrillation and two reverted to atrial flutter. Conclusions The GALAXY procedure is a safe and effective, minimally invasive method for treatment of isolated (lone) atrial fibrillation. The operation provides excellent short-term freedom from atrial fibrillation and should be considered in patients with isolated paroxysmal atrial fibrillation.


2018 ◽  
Vol 35 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Moisés Rodríguez‐Mañero ◽  
Bahij Kreidieh ◽  
Miguel Valderrábano ◽  
Aurora Baluja ◽  
Jose Luis Martínez‐Sande ◽  
...  

Author(s):  
Niv Ad ◽  
Sari Diana Holmes ◽  
Jay Patel ◽  
Hyung Gon Je ◽  
Deborah J. Shuman

Objective As with any medical therapy, identification of consistent and reliable outcome predictors is essential to understanding the efficacy of surgical ablation for atrial fibrillation. We originally intended to conduct a meta-analysis on atrial fibrillation surgical ablation to identify clinical factors that are most often associated with success. However, these studies are greatly heterogeneous. We conducted a systematic review to identify trends in outcome predictors and to provide recommendations for more uniform data analysis and reporting. Methods Relevant studies published between January 2005 and September 2013 were identified. To minimize heterogeneity, data were extracted only from multivariate analyses of outcome predictors. The initial approach for meta-analytic analyses was abandoned for a systematic review approach. Results From 604 initial citations, 19 studies with 5200 patients were included in the review. Systematic review of multivariable atrial fibrillation recurrence rates after surgical ablation revealed that studies were statistically heterogeneous, but atrial fibrillation recurrence after surgical ablation in mid-term follow-up was most often predicted by left atrium size, duration of atrial fibrillation, fine-wave atrial fibrillation, age of patient, and atrial fibrillation type. Conclusions The innate heterogeneity of published data precludes a meta-analysis for predictors of surgical ablation success. Of the few published studies that allow comparison, the most consistent predictors of failure were enlarged left atrium and long atrial fibrillation duration. These results underscore the need for consistent and reliable outcome predictors. We strongly recommend the development of a standardized system of measurement for consistent clinical parameters that can be used in outcome analyses for surgical ablation of atrial fibrillation.


Author(s):  
Nan Ma ◽  
Fangbao Ding ◽  
Zhaolei Jiang ◽  
Yin Chen ◽  
Fengqing Hu ◽  
...  

Surgical treatment is effective and less invasive for lone atrial fibrillation because of the emergence of the endoscopic technology and the adoption of new type of energy. On the basis of these improvements, we developed a new surgical ablation procedure by endoscopy for lone atrial fibrillation. The procedure enrolls only three ports on the left chest wall, which can provide pulmonary vein isolation, resection of the left atrial appendage, ganglionic plexus ablation, and make ablation of left atrium with direct vision. A total of 45 procedures were successfully performed. We reported the technique and result of the procedure.


BMJ Open ◽  
2016 ◽  
Vol 6 (11) ◽  
pp. e013273 ◽  
Author(s):  
Graham R McClure ◽  
Emilie P Belley-Cote ◽  
Rohit K Singal ◽  
Iqbal H Jaffer ◽  
Nazari Dvirnik ◽  
...  

Author(s):  
Davy C. H. Cheng ◽  
Niv Ad ◽  
Janet Martin ◽  
Eva E. Berglin ◽  
Byung-Chul Chang ◽  
...  

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