Total thoracoscopic ablation in patients with atrial fibrillation and left ventricular dysfunctionCentral MessagePerspective
Objective: To evaluate the effectiveness and safety of totally thoracoscopic ablation (TTA) in patients with left ventricular (LV) dysfunction for treatment of atrial fibrillation (AF) refractory to antiarrhythmic drug (AAD) therapy. Methods: Between January 2012 and December 2018, 31 patients under...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-08-01
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| Series: | JTCVS Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666250721002984 |
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| author | Hye Ree Kim, MD Dong-Seop Jeong, MD, PhD Hee-Jin Kwon, MD Seung-Jung Park, MD, PhD Kyoung-Min Park, MD, PhD June Soo Kim, MD, PhD Young Keun On, MD, PhD |
| author_facet | Hye Ree Kim, MD Dong-Seop Jeong, MD, PhD Hee-Jin Kwon, MD Seung-Jung Park, MD, PhD Kyoung-Min Park, MD, PhD June Soo Kim, MD, PhD Young Keun On, MD, PhD |
| author_sort | Hye Ree Kim, MD |
| collection | DOAJ |
| description | Objective: To evaluate the effectiveness and safety of totally thoracoscopic ablation (TTA) in patients with left ventricular (LV) dysfunction for treatment of atrial fibrillation (AF) refractory to antiarrhythmic drug (AAD) therapy. Methods: Between January 2012 and December 2018, 31 patients underwent TTA with drug-refractory AF and preoperative left ventricular ejection fraction (LVEF) <50% were included. Of the 31 patients, 8 received additional catheter ablation with an electrophysiologic study within 3 months after TTA. The rhythm outcome was obtained by 12-lead electrocardiography or 24-hour Holter monitoring. Results: The patient cohort had a mean age of 54.9 ± 9.0 years and consisted of 51.6% with persistent AF (n = 16), 45.2% with long-standing persistent AF (n = 14), and 3.2% with paroxysmal AF (n = 1). No patients died during the follow-up period. Compared with baseline, mean postoperative LVEF at 3 months (interquartile range [IQR], 2-6 months) increased significantly (from 39.7 ± 6.1% to 53.6 ± 9.3%; P < .001). At 25 months (IQR, 14-45 months), LVEF was sustained or further improved (from 39.7 ± 6.1% to 58.1 ± 7.5%; P < .001). The rate of sinus rhythm state was 93.5% (29 of 31), and freedom from arrhythmias off AADs after the final procedure was 61.3% (19 of 31) at a median follow-up of 32 months (IQR, 24-54 months). Conclusions: TTA is a safe and effective procedure that improves LV function and restores sinus rhythm in AF patients with LV dysfunction. |
| format | Article |
| id | doaj-art-41efe1ffb641460aa11ff90dbf5c128e |
| institution | Kabale University |
| issn | 2666-2507 |
| language | English |
| publishDate | 2021-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Techniques |
| spelling | doaj-art-41efe1ffb641460aa11ff90dbf5c128e2025-08-20T03:36:41ZengElsevierJTCVS Techniques2666-25072021-08-018606610.1016/j.xjtc.2021.04.006Total thoracoscopic ablation in patients with atrial fibrillation and left ventricular dysfunctionCentral MessagePerspectiveHye Ree Kim, MD0Dong-Seop Jeong, MD, PhD1Hee-Jin Kwon, MD2Seung-Jung Park, MD, PhD3Kyoung-Min Park, MD, PhD4June Soo Kim, MD, PhD5Young Keun On, MD, PhD6Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Heart, Vascular and Stroke Institute, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Cardiology, Department of Internal Medicine, Samsung Medical Center, Heart, Vascular and Stroke Institute, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Cardiology, Department of Internal Medicine, Samsung Medical Center, Heart, Vascular and Stroke Institute, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Cardiology, Department of Internal Medicine, Samsung Medical Center, Heart, Vascular and Stroke Institute, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Cardiology, Department of Internal Medicine, Samsung Medical Center, Heart, Vascular and Stroke Institute, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Cardiology, Department of Internal Medicine, Samsung Medical Center, Heart, Vascular and Stroke Institute, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Address for reprints: Young Keun On, MD, PhD, Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Heart, Vascular, and Stroke Institute, Sungkyunkwan University School of Medicine, 81 Irwin-ro, Gangnam-gu, Seoul 06351, Republic of Korea.Objective: To evaluate the effectiveness and safety of totally thoracoscopic ablation (TTA) in patients with left ventricular (LV) dysfunction for treatment of atrial fibrillation (AF) refractory to antiarrhythmic drug (AAD) therapy. Methods: Between January 2012 and December 2018, 31 patients underwent TTA with drug-refractory AF and preoperative left ventricular ejection fraction (LVEF) <50% were included. Of the 31 patients, 8 received additional catheter ablation with an electrophysiologic study within 3 months after TTA. The rhythm outcome was obtained by 12-lead electrocardiography or 24-hour Holter monitoring. Results: The patient cohort had a mean age of 54.9 ± 9.0 years and consisted of 51.6% with persistent AF (n = 16), 45.2% with long-standing persistent AF (n = 14), and 3.2% with paroxysmal AF (n = 1). No patients died during the follow-up period. Compared with baseline, mean postoperative LVEF at 3 months (interquartile range [IQR], 2-6 months) increased significantly (from 39.7 ± 6.1% to 53.6 ± 9.3%; P < .001). At 25 months (IQR, 14-45 months), LVEF was sustained or further improved (from 39.7 ± 6.1% to 58.1 ± 7.5%; P < .001). The rate of sinus rhythm state was 93.5% (29 of 31), and freedom from arrhythmias off AADs after the final procedure was 61.3% (19 of 31) at a median follow-up of 32 months (IQR, 24-54 months). Conclusions: TTA is a safe and effective procedure that improves LV function and restores sinus rhythm in AF patients with LV dysfunction.http://www.sciencedirect.com/science/article/pii/S2666250721002984totally thoracoscopic ablationsurgical ablationatrial fibrillationheart failureleft ventricular dysfunctioncatheter ablation |
| spellingShingle | Hye Ree Kim, MD Dong-Seop Jeong, MD, PhD Hee-Jin Kwon, MD Seung-Jung Park, MD, PhD Kyoung-Min Park, MD, PhD June Soo Kim, MD, PhD Young Keun On, MD, PhD Total thoracoscopic ablation in patients with atrial fibrillation and left ventricular dysfunctionCentral MessagePerspective JTCVS Techniques totally thoracoscopic ablation surgical ablation atrial fibrillation heart failure left ventricular dysfunction catheter ablation |
| title | Total thoracoscopic ablation in patients with atrial fibrillation and left ventricular dysfunctionCentral MessagePerspective |
| title_full | Total thoracoscopic ablation in patients with atrial fibrillation and left ventricular dysfunctionCentral MessagePerspective |
| title_fullStr | Total thoracoscopic ablation in patients with atrial fibrillation and left ventricular dysfunctionCentral MessagePerspective |
| title_full_unstemmed | Total thoracoscopic ablation in patients with atrial fibrillation and left ventricular dysfunctionCentral MessagePerspective |
| title_short | Total thoracoscopic ablation in patients with atrial fibrillation and left ventricular dysfunctionCentral MessagePerspective |
| title_sort | total thoracoscopic ablation in patients with atrial fibrillation and left ventricular dysfunctioncentral messageperspective |
| topic | totally thoracoscopic ablation surgical ablation atrial fibrillation heart failure left ventricular dysfunction catheter ablation |
| url | http://www.sciencedirect.com/science/article/pii/S2666250721002984 |
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