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
Hauptverfasser: Jansens, Jean Luc, Ducart, Anne, Preumont, Nicolas, Jottrand, Maurice, Stefanidis, Constantin, Stoupel, Eric, de Cannière, Didier
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container_end_page E598
container_issue 6
container_start_page E595
container_title The Heart surgery forum
container_volume 7
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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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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