Catheter ablation of symptomatic postoperative atrial arrhythmias after epicardial surgical disconnection of the pulmonary veins and left atrial appendage ligation in patients with atrial fibrillation.
Eur J Cardiothorac Surg
; 49(1): 265-71, 2016 Jan.
Article
em En
| MEDLINE
| ID: mdl-25721819
ABSTRACT
OBJECTIVES:
Minimally invasive thoracoscopic epicardial pulmonary vein isolation (MIPI) has an important role in the surgical treatment of atrial fibrillation (AF). However, the management of recurrent atrial arrhythmias after MIPI and long-term success rate of catheter ablation have not been well studied.METHODS:
Electrophysiological study was performed in 23 patients, 378 ± 282 days after MIPI surgery, because of recurrent symptomatic atrial arrhythmias.RESULTS:
A total of 20 patients presented with paroxysmal and persistent AF, 2 patients had a combination of AF and atrial tachycardia (AT) and 1 patient had a combination of AF and atrial flutter. All patients showed pulmonary vein (PV) reconnection. ATs were micro-re-entry PV-related ATs and atrial flutter was cavotricuspid isthmus dependent. Eighteen of 23 patients (78.3%) were free of atrial arrhythmias after one catheter ablation procedure at a mean follow-up of 50 ± 16 months. Three patients underwent a second ablation procedure for recurrent AF and macro-re-entry left atrial flutter. Eventually 20 of 23 patients (87%) remained free of atrial arrhythmias after a mean of 1.1 ± 0.3 ablation procedures.CONCLUSIONS:
Catheter ablation of recurrent atrial arrhythmias following MIPI for paroxysmal and persistent AF is a feasible and effective treatment with a good long-term success rate. Reconnection of PVs accounts for most recurrences.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Arritmias Cardíacas
/
Veias Pulmonares
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Ablação por Cateter
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Apêndice Atrial
Tipo de estudo:
Diagnostic_studies
/
Evaluation_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Eur J Cardiothorac Surg
Ano de publicação:
2016
Tipo de documento:
Article