Assisted Thoracoscopic Epicardial Ablation Of Atrial Fibrillation

Objective To review 35 cases of assisted thoracoscopic epicardial radiofrequency ablation for atrial fibrillation clinical experience. Of the surgical safety, efficiency and micro-surgical treatment of atrial fibrillation plane features and advantages, and discuss the emergence of this group of patients with complications related to proposed specific measures for treatment and care. Methods From July 2008 to November 2009, 35 patients with atrial fibrillation underwent a simple assisted thoracoscopic bilateral pulmonary vein isolation down. Indication for surgery without serious organic heart disease in patients with atrial fibrillation, paroxysmal atrial fibrillation and persistent types of atrial fibrillation include. Major operations, including a bilateral pulmonary vein isolation of left atrial ablation transitional Department, left atrial appendage removed, Marshall ligament transection,Epicardial part of the treatment to the nerve . Results Patients with no perioperative deaths. All cases are automatically restored to sinus rhythm, 4 patients had recurrence of atrial fibrillation. 1 patient perioperative left femoral artery embolism, 2 cases occurred three months after surgery with refractory atrial flutter, 1 case of wound healing occurs and lung infection. Were followed up to 6 months, no deaths and strokes occurred. Sinus rhythm rate after cardioversion: 82.85% (3 months), 85.71% (6 months).1 case of refractory atrial flutter by Ibrahimovic Litas March after cardioversion to sinus rhythm, and the other patients with refractory atrial flutter and interventional radiofrequency ablation sinus rhythm after cardioversion. Conclusion Video-assisted thoracoscopic epicardial radiofrequency ablation of atrial fibrillation following, in addition to maintaining the high cure rate of surgical treatment of atrial fibrillation, but also greatly reduce the surgical trauma, in the implementation of beating heart surgery, improved security, and the incidence of surgical complications low. This group of patients there had vein thrombosis and refractory arrhythmia and other complications are also due to hormone for postoperative wound healing and severe infection may be a reminder of the need for early postoperative adjustment of anticoagulation therapy to prevent thrombosis and hormone usage, some postoperative arrhythmia, may be left over after radiofrequency ablation and linear ablation of conduction gaps in the discontinuous and non-transmural related electrophysiological study should be strengthened and improved surgery, patients can be considered drugs and interventional treatment to improve the recovery rate of turn.