Totally Endoscopic Ablation of Left Atrium via Left Chest for Lone Atrial Fibrillation

2012 ◽  
Vol 7 (5) ◽  
pp. 382-384 ◽  
Author(s):  
Nan Ma ◽  
Fangbao Ding ◽  
Zhaolei Jiang ◽  
Yin Chen ◽  
Fengqing Hu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Ablation Procedure ◽  
Lone Atrial Fibrillation ◽  
Surgical Ablation ◽  
Left Chest ◽  
Endoscopic Ablation ◽  
New Type

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.

Surgical Treatment of Isolated (Lone) Atrial Fibrillation with Gemini-S Ablation and Left Atrial Appendage Excision (GALAXY Procedure)

2012 ◽  
Vol 7 (1) ◽  
pp. 33-38 ◽  
Author(s):  
John R. Doty ◽  
Stephen E. Clayson
Keyword(s):  
Atrial Fibrillation ◽  
Minimally Invasive ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Persistent Atrial Fibrillation ◽  
Atrial Appendage ◽  
Lone Atrial Fibrillation ◽  
Surgical Ablation ◽  
Invasive Approach ◽  
The Galaxy

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.

scholarly journals Effect of the Alterations in Contractility and Morphology Produced by Atrial Fibrillation on the Thrombosis Potential of the Left Atrial Appendage

2021 ◽  
Vol 9 ◽  
Author(s):  
Danila Vella ◽  
Alessandra Monteleone ◽  
Giulio Musotto ◽  
Giorgia Maria Bosi ◽  
Gaetano Burriesci
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Thrombus Formation ◽  
Fluid Dynamic ◽  
Atrial Appendage ◽  
Primary Role ◽  
Shear Strain Rate ◽  
Increased Risk

Atrial fibrillation (AF) is a common arrhythmia mainly affecting the elderly population, which can lead to serious complications such as stroke, ischaemic attack and vascular dementia. These problems are caused by thrombi which mostly originate in the left atrial appendage (LAA), a small muscular sac protruding from left atrium. The abnormal heart rhythm associated with AF results in alterations in the heart muscle contractions and in some reshaping of the cardiac chambers. This study aims to verify if and how these physiological changes can establish hemodynamic conditions in the LAA promoting thrombus formation, by means of computational fluid dynamic (CFD) analyses. In particular, sinus and fibrillation contractility was replicated by applying wall velocity/motion to models based on healthy and dilated idealized shapes of the left atrium with a common LAA morphology. The models were analyzed and compared in terms of shear strain rate (SSR) and vorticity, which are hemodynamic parameters directly associated with thrombogenicity. The study clearly indicates that the alterations in contractility and morphology associated with AF pathologies play a primary role in establishing hemodynamic conditions which promote higher incidence of ischaemic events, consistently with the clinical evidence. In particular, in the analyzed models, the impairment in contractility determined a decrease in SSR of about 50%, whilst the chamber pathological dilatation contributed to a 30% reduction, indicating increased risk of clot formation. The equivalent rigid wall model was characterized by SSR values about one order of magnitude smaller than in the contractile models, and substantially different vortical behavior, suggesting that analyses based on rigid chambers, although common in the literature, are inadequate to provide realistic results on the LAA hemodynamics.

scholarly journals Atrial Fibrillation Increases Production of Superoxide by the Left Atrium and Left Atrial Appendage

Circulation ◽  
2005 ◽  
Vol 112 (9) ◽  
pp. 1266-1273 ◽  
Author(s):  
Samuel C. Dudley ◽  
Nyssa E. Hoch ◽  
Louise A. McCann ◽  
Clegg Honeycutt ◽  
Laura Diamandopoulos ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage

scholarly journals Principles of Rhythm Management in Patients with Atrial Fibrillation

2020 ◽  
Vol 25 (1) ◽  
pp. 20-22
Author(s):  
Alexandra Kristine Tonch-Cerbu ◽  
Oana Stoia ◽  
Minodora Teodoru ◽  
Gabriela Eminovici
Keyword(s):  
Atrial Fibrillation ◽  
Flow Velocity ◽  
Transesophageal Echocardiography ◽  
Left Atrium ◽  
Population Study ◽  
Therapeutic Approach ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Rhythm Control ◽  
Echocardiographic Parameters

AbstractAtrial fibrillation is a multilateral arrhythmia, which causes the clinician to encounter difficulties in its therapeutic approach for each new patient. The purpose of this paper aims in particular at evaluating the management of atrial fibrillation, namely its cardioversion and rhythm control. The population study consisted of 50 patients diagnosed with atrial fibrillation, who underwent transesophageal echocardiographic investigation before cardioversion. All of these patients had transesophageal echocardiography. Certain echocardiographic parameters, such as the size of the left atrium, the presence of intracavitary thrombi, the left atrial appendage flow velocity, and the presence of spontaneous contrast, were taken into account. Cardioversion (electrical and pharmacological) was successful in 78.05% of patients. An appendage flow velocity greater than 40 cm/s, the absence of spontaneous contrast and the normal size of the left atrium, can be among the predictors of successful cardioversion.

Hemodynamic Changes in the Left Atrium due to Atrial Fibrillation

2011 ◽  
Author(s):  
Kenichi Funamoto ◽  
Ryo Koizumi ◽  
Toshiyuki Hayase ◽  
Muneichi Shibata ◽  
Tomoyuki Yambe
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
High Frequency ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Thrombus Formation ◽  
Pulmonary Veins ◽  
Hemodynamic Changes ◽  
Structure Interaction ◽  
Interaction Simulation

The left atrium (LA), which connects four pulmonary veins (PVs) to the left ventricle (LV), has a characteristic shape called the left atrial appendage (LAA) under the left PV. Atrial fibrillation (AF) is a heart disease, by which irregular electrical signals with high-frequency contraction (> 400 bpm) occur in the LA. Although AF itself is not fatal, it may cause thrombus formation, resulting to cerebral infarction. In this study, hemodynamics in the LA with/without AF was investigated by means of fluid-structure interaction simulation.

Thoracoscopic ablation for treatment of patients with lone atrial fibrillation in Russia

2018 ◽  
Vol 22 (2) ◽  
pp. 14 ◽  
Author(s):  
Oleg Yu. Pidanov ◽  
Alexander V. Bogachev-Prokophiev ◽  
Dmitry A. Elesin ◽  
Eduard A. Ivanitskiy ◽  
Oleg A. Bobrovskiy ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Russian Federation ◽  
Conflict Of Interest ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Lone Atrial Fibrillation ◽  
Results Of Treatment ◽  
Major Complications ◽  
Cardiac Surgeons

<p><strong>Aim.</strong> Endoscopic surgery demonstrates promising results of treatment in patients with non-paroxysmal atrial fibrillation. Minimally invasive thoracoscopic ablation contributes to the growing interest in such operations all over the world. Nowadays totally thoracoscopic ablations are available for patients in Russian Federation. Emphasis in our study was placed on the collection and analysis of data on thoracoscopic ablation procedures used for treating patients with lone atrial fibrillation.</p><p><strong>Methods.</strong> The study covered the operations performed by Russian cardiac surgeons over a period up until January 1, 2018. Data collection was based on emailed registration forms containing information about the date of procedures, type of ablation pattern, previous catheter procedures, used devices, methods of left atrial appendage closure and safety profile information. 30-day mortality, conversion to sternotomy/thoracotomy, stroke/ transient ischemic attack, reexplorations, cardiac tamponade and phrenic nerve damage were considered as major complications.</p><p><strong>Results</strong>. The study encompassed 10 cardiosurgical centers in Russian Federation where totally thoracoscopic ablations had been carried out between 2011– 2018. Six hundred fifty-two procedures were registered. Most patients were ablated in Dallas and Box Lesion patterns. Left atrial appendage exclusion was performed in 90,4% patients. Major complications were observed in 27 (4%) patients, mostly during the “learning curve” period.</p><p><strong>Conclusion.</strong> The given study is the first attempt to collect and systematize the data on a new surgical procedure for treatment of patients with atrial fibrillation. The data obtained allow for making a conclusion that thoracoscopic ablation is becoming a wide-spread surgical technique to treat patients with lone atrial fibrillation in Russia. The quantity of procedure increases annually. Introducing thoracoscopic procedures in clinical practice may be accompanied by complications at any center. Nevertheless, according to our investigation the rate of complications is low, which enables us to recommend thoracoscopic ablation to treat a numerous cohort of atrial fibrillation patients in Russia.</p><p>Received 13 June 2018. Revised 22 July 2018. Accepted 23 July 2018.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

Left Atrial Appendage Resection Versus Preservation During the Surgical Ablation of Atrial Fibrillation

2014 ◽  
Vol 97 (1) ◽  
pp. 124-132 ◽  
Author(s):  
Chee-Hoon Lee ◽  
Joon Bum Kim ◽  
Sung-Ho Jung ◽  
Suk Jung Choo ◽  
Cheol Hyun Chung ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Surgical Ablation
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