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Two-year follow-up of one-stage left unilateral thoracoscopic epicardial and transcatheter endocardial ablation for persistent and long-standing persistent atrial fibrillation

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A Correction to this article was published on 17 January 2020

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Abstract

Purpose

The purpose of this study was to analyze the efficacy and complication rates of a one-stage left unilateral thoracoscopic hybrid procedure in a series of patients with persistent and long-standing persistent atrial fibrillation (AF) in a 2-year follow-up.

Methods

Fifty-one consecutive patients (34 males, 65.7 ± 8 years) having undergone hybrid isolation of pulmonary veins (PVs) and posterior wall of left atrium (LA) by means of left unilateral hybrid thoracoscopic ablation for symptomatic persistent (n = 22, 43%) and long-standing persistent atrial fibrillation (AF) (n = 29, 57%) were analyzed.

Results

At a mean follow-up of 24.9 ± 11.8 months (median 24), the success rate without antiarrhythmic therapy was achieved in 68.6% of patients. Procedure-related major complications were observed in 2 patients (4%) including diaphragmatic perforation and late pericardial tamponade requiring mini left-sided thoracotomy and pericardial drainage, respectively. The success rate did not significantly differ between persistent and long-standing persistent AF (respectively, 68.2 and 69%; P = 0.89). Patients with AF relapse during the blanking period were 3.8 times more likely to have AF recurrence after 3 months from the ablation procedure.

Conclusion

The hybrid one-stage left unilateral thoracoscopic procedure exhibits encouraging results in the setting of both persistent and long-standing persistent AF after a 2-year follow-up, at a low rate of adverse events.

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Change history

  • 17 January 2020

    Owing to a type error during final correction and proof data submission to the journal, there were mistakes introduced into the legends of Fig. 3 and Fig. 4 as well as into the Y-axis title of the plot of Fig. 4.

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Author information

Author notes

  1. Carlo de Asmundis and Varnavas Varnavas contributed equally to the manuscript as first authorship.

  2. Gian-Battista Chierchia and Mark La Meir contributed equally to the manuscript as senior authorship.

Authors and Affiliations

  1. Heart Rhythm Management Centre, Postgraduate course in Cardiac Electrophysiology and Pacing, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium

    Carlo de Asmundis, Varnavas Varnavas, Juan Sieira, Erwin Ströker, Henrique E. Coutiño, Muryo Terasawa, Juan Pablo Abugattas, Francesca Salghetti, Riccardo Maj, Osório Thiago Guimarães, Saverio Iacopino, Pedro Brugada & Gian-Battista Chierchia

  2. Anesthesiology Departement, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium

    Vincent Umbrain & Jan Poelaert

  3. Department of Heart and Vessels, Careggi Hospital, Florence, Italy

    Sandro Gelsomino

  4. Cardiac Surgery Department, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel , Brussels, Belgium

    Mark La Meir

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  1. Carlo de Asmundis
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Corresponding author

Correspondence to Carlo de Asmundis.

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Conflict of interest

CdA receives compensation for teaching purposes and proctoring from AF Solutions, Medtronic, Abbott, Biotronik, and Atricure, and research grants on behalf of the center from Biotronik, Medtronic, St Jude Medical Abbot, Livanova, Boston Scientific, Biosense Webster, Atricure, and CardioTek. GBC receives compensation for teaching purposes and proctoring from AF Solutions and Medtronic. PB receives and speakers fees from Biotronik and Medtronic. MLM is a consultant for Atricure.

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de Asmundis, C., Varnavas, V., Sieira, J. et al. Two-year follow-up of one-stage left unilateral thoracoscopic epicardial and transcatheter endocardial ablation for persistent and long-standing persistent atrial fibrillation. J Interv Card Electrophysiol 58, 333–343 (2020). https://doi.org/10.1007/s10840-019-00616-w

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