Surgical minimally invasive pulmonary vein isolation for lone atrial fibrillation: Midterm results of a multicenter study

Gijs E. De Maat, Alberto Pozzoli, Marcoen F. Scholten, Hans L. Hillege, Isabelle C. Van Gelder, Ottavio R. Alfieri, Stefano Benussi, Massimo A. Mariani

Research output: Contribution to journalArticlepeer-review

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±SDagewas54±11years,and 78%weremen. The median AF duration was 30 months (range, 2-203); paroxysmal AFwas 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 multi center 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.

Original languageEnglish
Pages (from-to)410-415
Number of pages6
JournalInnovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Volume8
Issue number6
DOIs
Publication statusPublished - Nov 2013

Keywords

  • Atrial fibrillation
  • Minimally invasive surgery
  • Pulmonary vein isolation
  • VATS

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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