Pulmonary vein isolation by robotic-enhanced thoracoscopy for symptomatic paroxysmal atrial fibrillation
Pulmonary vein isolation (PVI) has been shown to be effective treatment of patients with symptomatic paroxysmal atrial fibrillation (PAF). The percutaneous approach is currently the technique of choice. Unfortunately, this procedure has limitations and complications that lead to fluctuating success...
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Veröffentlicht in: | The Heart surgery forum 2004-01, Vol.7 (6), p.E595-E598 |
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creator | Jansens, Jean Luc Ducart, Anne Preumont, Nicolas Jottrand, Maurice Stefanidis, Constantin Stoupel, Eric de Cannière, Didier |
description | Pulmonary vein isolation (PVI) has been shown to be effective treatment of patients with symptomatic paroxysmal atrial fibrillation (PAF). The percutaneous approach is currently the technique of choice. Unfortunately, this procedure has limitations and complications that lead to fluctuating success rates. We explored an alternative technique of robotic-enhanced, closed-chest PVI with an endoscopic microwave-based catheter.
Seven symptomatic PAF patients were included in the study. The pulmonary veins were isolated through right (only) robotic-enhanced thoracoscopy on the beating heart.
Six patients underwent successful endoscopic PVI. In 1 patient the operation was converted into small right thoracotomy. Operative assessment of the ablation line showed a successful electric block in every patient. Three months after the procedure, the first 5 patients were in permanent sinus rhythm. The 2 other patients had AF but had less frequent and less symptomatic episodes compared with the preoperative situation.
On the basis of this preliminary experience, we believe that in the near future endoscopic right-chest robotic-enhanced PVI on the beating heart may become a valid option in the treatment of symptomatic PAF patients. This procedure allows for more-reproducible ablation lines and may avoid many of the pitfalls and drawbacks of the percutaneous approach. Therefore this technique deserves larger prospective evaluation in the treatment of AF. |
doi_str_mv | 10.1532/hsf98.20041107 |
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Seven symptomatic PAF patients were included in the study. The pulmonary veins were isolated through right (only) robotic-enhanced thoracoscopy on the beating heart.
Six patients underwent successful endoscopic PVI. In 1 patient the operation was converted into small right thoracotomy. Operative assessment of the ablation line showed a successful electric block in every patient. Three months after the procedure, the first 5 patients were in permanent sinus rhythm. The 2 other patients had AF but had less frequent and less symptomatic episodes compared with the preoperative situation.
On the basis of this preliminary experience, we believe that in the near future endoscopic right-chest robotic-enhanced PVI on the beating heart may become a valid option in the treatment of symptomatic PAF patients. This procedure allows for more-reproducible ablation lines and may avoid many of the pitfalls and drawbacks of the percutaneous approach. Therefore this technique deserves larger prospective evaluation in the treatment of AF.</description><identifier>ISSN: 1098-3511</identifier><identifier>EISSN: 1522-6662</identifier><identifier>DOI: 10.1532/hsf98.20041107</identifier><identifier>PMID: 15769694</identifier><language>eng</language><publisher>United States</publisher><subject>Atrial Fibrillation - surgery ; Endoscopy - methods ; Feasibility Studies ; Female ; Heart Conduction System - surgery ; Humans ; Male ; Middle Aged ; Pulmonary Veins - surgery ; Robotics - methods ; Surgery, Computer-Assisted - methods ; Thoracic Surgical Procedures - methods ; Treatment Outcome</subject><ispartof>The Heart surgery forum, 2004-01, Vol.7 (6), p.E595-E598</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c392t-4d8376d5c8afee4eda8f669ce0741bbf7d5cb4c65038d276c1f1671b78e549ed3</citedby><cites>FETCH-LOGICAL-c392t-4d8376d5c8afee4eda8f669ce0741bbf7d5cb4c65038d276c1f1671b78e549ed3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15769694$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jansens, Jean Luc</creatorcontrib><creatorcontrib>Ducart, Anne</creatorcontrib><creatorcontrib>Preumont, Nicolas</creatorcontrib><creatorcontrib>Jottrand, Maurice</creatorcontrib><creatorcontrib>Stefanidis, Constantin</creatorcontrib><creatorcontrib>Stoupel, Eric</creatorcontrib><creatorcontrib>de Cannière, Didier</creatorcontrib><title>Pulmonary vein isolation by robotic-enhanced thoracoscopy for symptomatic paroxysmal atrial fibrillation</title><title>The Heart surgery forum</title><addtitle>Heart Surg Forum</addtitle><description>Pulmonary vein isolation (PVI) has been shown to be effective treatment of patients with symptomatic paroxysmal atrial fibrillation (PAF). The percutaneous approach is currently the technique of choice. Unfortunately, this procedure has limitations and complications that lead to fluctuating success rates. We explored an alternative technique of robotic-enhanced, closed-chest PVI with an endoscopic microwave-based catheter.
Seven symptomatic PAF patients were included in the study. The pulmonary veins were isolated through right (only) robotic-enhanced thoracoscopy on the beating heart.
Six patients underwent successful endoscopic PVI. In 1 patient the operation was converted into small right thoracotomy. Operative assessment of the ablation line showed a successful electric block in every patient. Three months after the procedure, the first 5 patients were in permanent sinus rhythm. The 2 other patients had AF but had less frequent and less symptomatic episodes compared with the preoperative situation.
On the basis of this preliminary experience, we believe that in the near future endoscopic right-chest robotic-enhanced PVI on the beating heart may become a valid option in the treatment of symptomatic PAF patients. This procedure allows for more-reproducible ablation lines and may avoid many of the pitfalls and drawbacks of the percutaneous approach. Therefore this technique deserves larger prospective evaluation in the treatment of AF.</description><subject>Atrial Fibrillation - surgery</subject><subject>Endoscopy - methods</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Heart Conduction System - surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pulmonary Veins - surgery</subject><subject>Robotics - methods</subject><subject>Surgery, Computer-Assisted - methods</subject><subject>Thoracic Surgical Procedures - methods</subject><subject>Treatment Outcome</subject><issn>1098-3511</issn><issn>1522-6662</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkE1LxDAYhIMo7rp69Sg5eeuapG0-jrK4rrCgoJ5LkiY00jY1acX-eyO74mkG3pnh5QHgGqM1LnNy10Qr-JogVGCM2AlY4pKQjFJKTpNHgmd5ifECXMT4gRChhNBzsMAlo4KKYgmal6ntfC_DDL-M66GLvpWj8z1UMwxe-dHpzPSN7LWp4dj4ILWP2g8ztD7AOHfD6LvU0HCQwX_PsZMtlGNwSaxTwbWHvUtwZmUbzdVRV-B9-_C22WX758enzf0-07kgY1bUPGe0LjWX1pjC1JJbSoU2iBVYKcvSSRWalijnNWFUY4spw4pxUxbC1PkK3B52h-A_JxPHqnNRm_RFb_wUK8oIFxSzFFwfgjr4GIOx1RBcl0BUGFW_bKvd61bw6o9tKtwclyfVmfo_foSZ_wDGZHhJ</recordid><startdate>20040101</startdate><enddate>20040101</enddate><creator>Jansens, Jean Luc</creator><creator>Ducart, Anne</creator><creator>Preumont, Nicolas</creator><creator>Jottrand, Maurice</creator><creator>Stefanidis, Constantin</creator><creator>Stoupel, Eric</creator><creator>de Cannière, Didier</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20040101</creationdate><title>Pulmonary vein isolation by robotic-enhanced thoracoscopy for symptomatic paroxysmal atrial fibrillation</title><author>Jansens, Jean Luc ; Ducart, Anne ; Preumont, Nicolas ; Jottrand, Maurice ; Stefanidis, Constantin ; Stoupel, Eric ; de Cannière, Didier</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c392t-4d8376d5c8afee4eda8f669ce0741bbf7d5cb4c65038d276c1f1671b78e549ed3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Atrial Fibrillation - surgery</topic><topic>Endoscopy - methods</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Heart Conduction System - surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pulmonary Veins - surgery</topic><topic>Robotics - methods</topic><topic>Surgery, Computer-Assisted - methods</topic><topic>Thoracic Surgical Procedures - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jansens, Jean Luc</creatorcontrib><creatorcontrib>Ducart, Anne</creatorcontrib><creatorcontrib>Preumont, Nicolas</creatorcontrib><creatorcontrib>Jottrand, Maurice</creatorcontrib><creatorcontrib>Stefanidis, Constantin</creatorcontrib><creatorcontrib>Stoupel, Eric</creatorcontrib><creatorcontrib>de Cannière, Didier</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Heart surgery forum</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jansens, Jean Luc</au><au>Ducart, Anne</au><au>Preumont, Nicolas</au><au>Jottrand, Maurice</au><au>Stefanidis, Constantin</au><au>Stoupel, Eric</au><au>de Cannière, Didier</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pulmonary vein isolation by robotic-enhanced thoracoscopy for symptomatic paroxysmal atrial fibrillation</atitle><jtitle>The Heart surgery forum</jtitle><addtitle>Heart Surg Forum</addtitle><date>2004-01-01</date><risdate>2004</risdate><volume>7</volume><issue>6</issue><spage>E595</spage><epage>E598</epage><pages>E595-E598</pages><issn>1098-3511</issn><eissn>1522-6662</eissn><abstract>Pulmonary vein isolation (PVI) has been shown to be effective treatment of patients with symptomatic paroxysmal atrial fibrillation (PAF). The percutaneous approach is currently the technique of choice. Unfortunately, this procedure has limitations and complications that lead to fluctuating success rates. We explored an alternative technique of robotic-enhanced, closed-chest PVI with an endoscopic microwave-based catheter.
Seven symptomatic PAF patients were included in the study. The pulmonary veins were isolated through right (only) robotic-enhanced thoracoscopy on the beating heart.
Six patients underwent successful endoscopic PVI. In 1 patient the operation was converted into small right thoracotomy. Operative assessment of the ablation line showed a successful electric block in every patient. Three months after the procedure, the first 5 patients were in permanent sinus rhythm. The 2 other patients had AF but had less frequent and less symptomatic episodes compared with the preoperative situation.
On the basis of this preliminary experience, we believe that in the near future endoscopic right-chest robotic-enhanced PVI on the beating heart may become a valid option in the treatment of symptomatic PAF patients. This procedure allows for more-reproducible ablation lines and may avoid many of the pitfalls and drawbacks of the percutaneous approach. Therefore this technique deserves larger prospective evaluation in the treatment of AF.</abstract><cop>United States</cop><pmid>15769694</pmid><doi>10.1532/hsf98.20041107</doi></addata></record> |
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subjects | Atrial Fibrillation - surgery Endoscopy - methods Feasibility Studies Female Heart Conduction System - surgery Humans Male Middle Aged Pulmonary Veins - surgery Robotics - methods Surgery, Computer-Assisted - methods Thoracic Surgical Procedures - methods Treatment Outcome |
title | Pulmonary vein isolation by robotic-enhanced thoracoscopy for symptomatic paroxysmal atrial fibrillation |
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