Thoracoscopic surgery for paroxysmal atrial fibrillation

Vachev S.A.; Korolev S.V.; Konev A.V.; Dupik N.V.; Zotov A.S.; Khabazov R.I.; Troitsky A.V.

doi:https://doi.org/10.17116/kardio20211401120

Vachev S.A.

Federal Research Clinical Center of Specialized Medical Care and Medical Technologies

ORCID: 0000-0002-2747-3057

Korolev S.V.

Federal Research Clinical Center of Specialized Medical Care and Medical Technologies

Konev A.V.

Federal Research Clinical Center of Specialized Medical Care and Medical Technologies

Dupik N.V.

Federal Research Clinical Center of Specialized Medical Care and Medical Technologies

Zotov A.S.

Federal Research Clinical Center of Specialized Medical Care and Medical Technologies

ORCID: 0000-0003-0494-0211

Khabazov R.I.

Federal Research Clinical Center of Specialized Medical Care and Medical Technologies

Troitsky A.V.

Federal Research Clinical Center of Specialized Medical Care and Medical Technologies

Thoracoscopic surgery for paroxysmal atrial fibrillation

Authors:

Vachev S.A., Korolev S.V., Konev A.V., Dupik N.V., Zotov A.S., Khabazov R.I., Troitsky A.V.

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Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2021;14(1): 20‑25

DOI: 10.17116/kardio20211401120

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To cite this article:

Vachev SA, Korolev SV, Konev AV, Dupik NV, Zotov AS, Khabazov RI, Troitsky AV. Thoracoscopic surgery for paroxysmal atrial fibrillation. Russian Journal of Cardiology and Cardiovascular Surgery. 2021;14(1):20‑25. (In Russ.)
https://doi.org/10.17116/kardio20211401120

Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To clarify the indications for thoracoscopic radiofrequency ablation of the left atrium in patients with paroxysmal atrial fibrillation.

MATERIAL AND METHODS

The study included 194 consecutive patients with atrial fibrillation. All patients were operated for the period from April 2017 to November 2019. The minimum postoperative follow-up was 6 months. All patients were divided into 2 groups depending on surgery: group 1 (n=128, 66%) — balloon ablation of pulmonary vein (catheter surgery; all patients with paroxysmal atrial fibrillation); group 2 (n=66, 34%) — radiofrequency fragmentation of the left atrium with resection of the left atrial appendage (thoracoscopic surgery; 60 patients with non-paroxysmal atrial fibrillation, 6 ones with paroxysmal fibrillation).

RESULTS

Data on heart rhythm and its disturbances were obtained from 100% of patients by May 31, 2020. In 28 (22%) patients of group 1, recurrent postoperative atrial fibrillation occurred. In one patient, this paroxysm coincided with transient ischemic attack. In the 2^nd group, recurrent atrial fibrillation was observed in 2 (3%) patients. Both patients suffered from preoperative non-paroxysmal atrial fibrillation. None of 6 patients in this group with preoperative paroxysmal atrial fibrillation had postoperative recurrence. There were no thromboembolic events in the 2^nd group throughout the entire follow-up period. Thus, thoracoscopic radiofrequency fragmentation ensured more effective long-term heart rhythm control (p<0.001). Therefore, we can talk about less risk of thromboembolic complications after thoracoscopic surgery compared to endovascular procedure considering simultaneous resection of the left atrial appendage.

CONCLUSION

Thoracoscopic radiofrequency fragmentation of the left atrium is advisable in patients with paroxysmal atrial fibrillation and contraindications for oral anticoagulation.

Keywords:

atrial fibrillation

thromboembolic complications

thoracoscopic surgery

radiofrequency ablation

cryoballoon ablation

Authors:

Vachev S.A.

Federal Research Clinical Center of Specialized Medical Care and Medical Technologies

ORCID: 0000-0002-2747-3057

Korolev S.V.

Federal Research Clinical Center of Specialized Medical Care and Medical Technologies

Konev A.V.

Federal Research Clinical Center of Specialized Medical Care and Medical Technologies

Dupik N.V.

Federal Research Clinical Center of Specialized Medical Care and Medical Technologies

Zotov A.S.

Federal Research Clinical Center of Specialized Medical Care and Medical Technologies

ORCID: 0000-0003-0494-0211

Khabazov R.I.

Federal Research Clinical Center of Specialized Medical Care and Medical Technologies

Troitsky A.V.

Federal Research Clinical Center of Specialized Medical Care and Medical Technologies

Received:

04.08.2020

Accepted:

10.09.2020

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References:

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