Safety and long-term efficacy of thoracoscopic Epicardial ablation in patients with paroxysmal atrial fibrillation: a retrospective study
| العنوان: | Safety and long-term efficacy of thoracoscopic Epicardial ablation in patients with paroxysmal atrial fibrillation: a retrospective study |
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| المؤلفون: | Mohammed Osman, Sudarshan Balla, John Johnkoski, Bryan Miles, Muhammad Bilal Munir, Anna J. Sudbury, Mina M. Benjamin |
| المصدر: | Journal of Cardiothoracic Surgery, Vol 14, Iss 1, Pp 1-6 (2019) Journal of cardiothoracic surgery, vol 14, iss 1 Journal of Cardiothoracic Surgery |
| بيانات النشر: | BMC, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Male, Ablation Techniques, medicine.medical_treatment, Respiratory System, 030204 cardiovascular system & hematology, Cardiovascular, Pulmonary vein, 0302 clinical medicine, Implantable loop recorder, Atrial fibrillation, General Medicine, Middle Aged, Cardiac surgery, Treatment Outcome, Heart Disease, Pneumothorax, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, Arrhythmia, Research Article, Pulmonary and Respiratory Medicine, Adult, medicine.medical_specialty, Clinical Sciences, lcsh:Surgery, Pulmonary vein isolation, lcsh:RD78.3-87.3, 03 medical and health sciences, Anticoagulation, Clinical Research, medicine, Humans, Thoracoscopic, Heart Atria, Atrial tachycardia, Retrospective Studies, Aged, business.industry, Thoracoscopy, Retrospective cohort study, lcsh:RD1-811, medicine.disease, Surgery, Chest tube, 030228 respiratory system, lcsh:Anesthesiology, business, Epicardial ablation, Follow-Up Studies |
| الوصف: | Background The aim of this study is to report the long-term efficacy and safety of thoracoscopic epicardial left atrial ablation (TELA) in patients with paroxysmal atrial fibrillation (AF). Methods This was a retrospective review of medical records. We included all patients diagnosed with paroxysmal AF who underwent TELA at our institution between 04/2011 and 06/2017. TELA included pulmonary vein isolation, LA dome lesions and LA appendage exclusion. All (n = 55) patients received an implantable loop recorder (ILR), 30 days post-operatively. Antiarrhythmic and anticoagulation therapy were discontinued at 90 and 180 days postoperatively, respectively, if patients were free of AF recurrence. Failure was defined as ≥two minutes of continuous AF, or atrial tachycardia. Results Fifty-five patients (78% males, mean age = 61.6 years) qualified for the study. The average duration in AF was 3.64 +/− 3.4 years, mean CHA2DS2-VASc Score was 2.0 +/− 1.6. The procedure was attempted in 57 patients and completed successfully in 55 (96.5%). Two patients experienced a minor pulmonary vein bleed that was managed conservatively. Post procedure, one patient experienced pulmonary edema, another experienced a pneumothorax requiring a chest tube and another experienced acute respiratory distress syndrome resulting in longer hospitalization. Otherwise, there were no major procedural complications. Success rates were 89.1% (n = 49/55), 85.5% (n = 47/55) and 76.9% (n = 40/52) at 6, 12 and 24 months, respectively. In the multivariate cox-proportional hazard model, survival at the mean of covariates was 86 and 74% at 12 and 24 months, respectively. Conclusion In this single center experience, TELA was a safe and efficacious procedure for patients with paroxysmal AF. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1749-8090 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9427274f04295c6947d520439700ac88Test http://link.springer.com/article/10.1186/s13019-019-1018-4Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....9427274f04295c6947d520439700ac88 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17498090 |
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