PMID- 30118710
OWN - NLM
STAT- In-Data-Review
LR  - 20181026
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 106
IP  - 5
DP  - 2018 Nov
TI  - En Bloc Left Pulmonary Vein and Appendage Isolation in Thoracoscopic Surgery for 
      Atrial Fibrillation.
PG  - 1340-1347
LID - S0003-4975(18)31134-2 [pii]
LID - 10.1016/j.athoracsur.2018.06.065 [doi]
AB  - BACKGROUND: We evaluated the safety and rhythm control effectiveness in en bloc
      isolation of the left pulmonary vein (PV) and appendage conducted as part of the 
      thoracoscopic procedure for bilateral PV isolation, non-PV ablation, and
      appendage closure for atrial fibrillation (AF). METHODS: Procedural safety was
      evaluated by reviewing the surgical records. Rhythm control was examined in
      accordance with the Heart Rhythm Society guidelines at postoperative months 1, 3,
      6, and 12, and yearly thereafter. The sinus rhythm rates at postoperative years 1
      and 2 were compared with the corresponding data from our previous procedure
      without the en bloc technique. RESULTS: Starting in 2014, the en bloc technique
      was applied to 238 nonvalvular AF patients and successfully performed in all but 
      23 patients. The mean operation time was 88 minutes. There were no hospital
      deaths or major procedure-related complications. The mean follow-up period was
      1.7 years. The sinus rhythm rates at postoperative years 1 and 2 were 85% and 80%
      in paroxysmal, 76% and 70% in persistent, and 67% and 61% in long-standing
      persistent AF, respectively, without antiarrhythmic drug use. Compared with the
      previous procedure (n = 324), sinus rhythm rates were higher in long-standing
      persistent AF (67% vs 50% at 1 year and 61% vs 40% at 2 years; p = 0.04). No
      patients suffered cardiogenic thromboembolisms without anticoagulation.
      CONCLUSIONS: Thoracoscopic en bloc left PV and appendage isolation was safely
      achieved in most patients. Using this technique may contribute to better rhythm
      control results than not using it in cases of long-standing persistent AF.
CI  - Copyright (c) 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc.
      All rights reserved.
FAU - Ohtsuka, Toshiya
AU  - Ohtsuka T
AD  - Department of Cardiovascular Surgery, Tokyo Metropolitan Tama Medical Center,
      Tokyo, Japan. Electronic address: ootsukadr@sd6.so-net.ne.jp.
FAU - Nonaka, Takahiro
AU  - Nonaka T
AD  - Department of Cardiovascular Surgery, Tokyo Metropolitan Tama Medical Center,
      Tokyo, Japan.
FAU - Hisagi, Motoyuki
AU  - Hisagi M
AD  - Department of Cardiovascular Surgery, Tokyo Metropolitan Tama Medical Center,
      Tokyo, Japan.
FAU - Ninomiya, Mikio
AU  - Ninomiya M
AD  - Department of Cardiovascular Surgery, Tokyo Metropolitan Tama Medical Center,
      Tokyo, Japan.
LA  - eng
PT  - Journal Article
DEP - 20180814
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
EDAT- 2018/08/18 06:00
MHDA- 2018/08/18 06:00
CRDT- 2018/08/18 06:00
PHST- 2018/01/24 00:00 [received]
PHST- 2018/05/30 00:00 [revised]
PHST- 2018/06/20 00:00 [accepted]
PHST- 2018/08/18 06:00 [pubmed]
PHST- 2018/08/18 06:00 [medline]
PHST- 2018/08/18 06:00 [entrez]
AID - S0003-4975(18)31134-2 [pii]
AID - 10.1016/j.athoracsur.2018.06.065 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2018 Nov;106(5):1340-1347. doi:
      10.1016/j.athoracsur.2018.06.065. Epub 2018 Aug 14.