Subgroup analysis demonstrated similar trends , with higher freedom from AF in the surgical ablation group for paroxysmal AF patients .
The incidence of pacemaker implantation was higher , while no difference in stroke or cardiac tamponade was demonstrated for the surgical versus catheter ablation groups .
Current evidence suggests that epicardial ablative strategies are associated with higher freedom from AF , higher pacemaker implantation rates and comparable neurological complications and cardiac tamponade incidence to catheter ablative treatment .
BACKGROUND Atrial fibrillation ( AF ) is an increasingly prevalent condition in the ageing population , with significantly associated morbidity and mortality .
Surgical and catheter ablative strategies both aim to reduce mortality and morbidity through freedom from AF .
This review consoli date s all currently available comparative data to evaluate these two interventions .
Feasibility and efficacy of minimally invasive stand-alone surgical ablation of atrial fibrillation. A single-center experience
Purpose Minimally invasive surgical ablation for atrial fibrillation ( AF ) has shown good results and low complications incidence . Our objective was to evaluate feasibility and efficacy of this technique in our center . Methods The procedure included pulmonary vein isolation , ganglionic plexi ablation , ligament of Marshall resection , and left atrial appendage exclusion through beating heart minimally invasive bilateral thoracotomies . Patients were monitored daily by telemedicine during the first 4 months and then by quarterly 24-h Holter monitoring or by implantable cardiac monitor . Ablation success was defined as freedom from any atrial tachyarrhythmia recurrence lasting more than 30 s and from antiarrhythmic drugs . All patients were followed up for a minimum of 12 months . Results Twenty-two consecutive patients with AF , paroxysmal in 27 % and persistent in 73 % , were treated . Mean age was 63 ± 10 years , 86 % were men . Seventy-three percent of patients had previously undergone to one or more catheter ablations . Median follow-up period was 22 months ( 25 ° –75 ° percentile , 20–27 ) . Patients free from any arrhythmia recurrence for at least 6 consecutive months discontinued antiarrhythmic therapy . Ablation was successful in 73 % of patients at 12 months . Freedom from AF recurrences independently from antiarrhythmic therapy status was 91 % at 12 months . Results were consistent in patients that reached 24 months follow-up . There were no deaths . Complications were : one conversion to sternotomy owing to thoracic adherences , one pacemaker implant , and one postoperative hemothorax requiring surgical revision . Conclusions Our results show that minimally invasive surgical ablation was feasible and gave satisfactory results at long-term term follow-up in patients with AF
Subgroup analysis demonstrated similar trends , with higher freedom from AF in the surgical ablation group for paroxysmal AF patients .
The incidence of pacemaker implantation was higher , while no difference in stroke or cardiac tamponade was demonstrated for the surgical versus catheter ablation groups .
Current evidence suggests that epicardial ablative strategies are associated with higher freedom from AF , higher pacemaker implantation rates and comparable neurological complications and cardiac tamponade incidence to catheter ablative treatment .
BACKGROUND Atrial fibrillation ( AF ) is an increasingly prevalent condition in the ageing population , with significantly associated morbidity and mortality .
Surgical and catheter ablative strategies both aim to reduce mortality and morbidity through freedom from AF .
This review consoli date s all currently available comparative data to evaluate these two interventions .