Management of Recurrent Atrial Arrhythmias After Minimally Invasive Surgical Pulmonary Vein Isolation and Ganglionic Plexi Ablation for Atrial Fibrillation

Heart Rhythm ◽  
2010 ◽  
Vol 7 (4) ◽  
pp. 445-451 ◽  
Author(s):  
Jordana Kron ◽  
Vigneshwar Kasirajan ◽  
Mark A. Wood ◽  
Marcin Kowalski ◽  
Frederick T. Han ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Minimally Invasive ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Atrial Arrhythmias ◽  
Minimally Invasive Surgical

Rationale for Minimally Invasive Pulmonary Vein Isolation and Partial Autonomic Denervation for Surgical Treatment of Atrial Fibrillation

2008 ◽  
Vol 3 (3) ◽  
pp. 121-124 ◽  
Author(s):  
Zachary J. Edgerton ◽  
James R. Edgerton
Keyword(s):  
Atrial Fibrillation ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Surgical Approach ◽  
Evidence Based ◽  
Autonomic Denervation ◽  
Minimally Invasive Surgical ◽  
Invasive Surgical Approach

We seek to demonstrate the rationale of a minimally invasive surgical approach to the treatment of atrial fibrillation which combines pulmonary vein antral isolation with targeted partial autonomic denervation. The literature supporting the rationale of this approach is reviewed. There is evidence-based literature that supports both pulmonary vein electrical isolation and targeted partial autonomic denervation in the treatment of atrial fibrillation. These techniques can be combined in a minimally invasive surgical approach.

scholarly journals Results of a Minimally Invasive Surgical Pulmonary Vein Isolation and Ganglionic Plexi Ablation for Atrial Fibrillation

2009 ◽  
Vol 2 (4) ◽  
pp. 370-377 ◽  
Author(s):  
Frederick T. Han ◽  
Vigneshwar Kasirajan ◽  
Marcin Kowalski ◽  
Robert Kiser ◽  
Luke Wolfe ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Minimally Invasive ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Minimally Invasive Surgical

Surgical Minimally Invasive Pulmonary Vein Isolation for Lone Atrial Fibrillation

2013 ◽  
Vol 8 (6) ◽  
pp. 410-415 ◽  
Author(s):  
Gijs E. De Maat ◽  
Alberto Pozzoli ◽  
Marcoen F. Scholten ◽  
Hans L. Hillege ◽  
Isabelle C. Van Gelder ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Adverse Events ◽  
Minimally Invasive ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Multicenter Study ◽  
Long Term Results ◽  
Lone Atrial Fibrillation ◽  
Retrospective Multicenter Study

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.

scholarly journals Prevalence and Predictors of Additional Ablation Beyond Pulmonary Vein Isolation in Patients With Paroxysmal Atrial Fibrillation

2021 ◽  
Vol 8 ◽  
Author(s):  
Xin Xie ◽  
Gang Yang ◽  
Xiaorong Li ◽  
Jinbo Yu ◽  
Fengxiang Zhang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Paroxysmal Atrial Fibrillation ◽  
Low Voltage ◽  
Electrophysiological Study ◽  
Atrial Arrhythmias ◽  
Limited Data ◽  
Index Procedure ◽  
Single Procedure

Background: Pulmonary vein isolation (PVI) is an effective strategy in the treatment of paroxysmal atrial fibrillation (PAF). Yet, there are limited data on additional ablation beyond PVI. In this study, we sought to assess the prevalence, predictors, and outcomes of additional ablation in PAF patients.Methods: A total of 537 consecutive patients with PAF were retrospectively evaluated for the index procedure. PVI was successfully conducted in all patients, after which electrophysiological study and drug provocation were performed, and additional ablations were delivered for concomitant arrhythmias, non-PV triggers, and low voltage zone (LVZ). The prevalence, predictors, and outcomes of additional ablation were analyzed.Results: Among 537 consecutive patients, 372 addition ablations were performed in 241 (44.88%) patients, including 252 (67.74%) concomitant arrhythmias in 198 (36.87%) patients, 56 (15.05%) non-PV triggers in 52 (9.68%) patients and 64 (17.20%) LVZ modification in 47 (8.75%) patients. Lower LVEF (OR = 0.937, p = 0.015), AF episode before procedure (OR = 2.990, p = 0.001), AF episode during procedure (OR = 1.998, p = 0.002) and AF episode induced after PVI (OR = 15.958, p < 0.001) were independent predictors of additional ablation. Single-procedure free from atrial arrhythmias at 58.36 ± 7.12 months post-ablation was 70.48%.Conclusions: Additional ablations were common in patients with PAF for index procedure. Lower LVEF and AF episodes before, during the procedure, and induced after PVI predicts additional ablation.

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