Pearman, Charles M, Redfern, James, Williams, Emmanuel A 
ORCID: 0000-0002-4898-6206, Snowdon, Richard L, Modi, Paul, Hall, Mark CS, Modi, Simon, Waktare, Johan EP, Mahida, Saagar, Todd, Derick M et al (show 2 more authors)
(2019)
Early experience of thoracoscopic vs. catheter ablation for atrial fibrillation.
EUROPACE, 21 (5).
pp. 738-745.
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Abstract
<h4>Aims</h4>Video-assisted thoracoscopic surgery (VATS) ablation has been advocated as a treatment option for non-paroxysmal atrial fibrillation (AF) in recent guidelines. Real-life data on its safety and efficacy during a centre's early experience are sparse.<h4>Methods and results</h4>Thirty patients (28 persistent/longstanding persistent AF) underwent standalone VATS ablation for AF by an experienced thoracoscopic surgeon, with the first 20 cases proctored by external surgeons. Procedural and follow-up outcomes were collected prospectively, and compared with 90 propensity-matched patients undergoing contemporaneous catheter ablation (CA). Six (20.0%) patients undergoing VATS ablation experienced ≥1 major complication (death n = 1, stroke n = 2, conversion to sternotomy n = 3, and phrenic nerve injury n = 2). This was significantly higher than the 1.1% major complication rate (tamponade requiring drainage n = 1) seen with CA (P < 0.001). Twelve-month single procedure arrhythmia-free survival rates without antiarrhythmic drugs were 56% in the VATS and 57% in the CA cohorts (P = 0.22), and 78% and 80%, respectively given an additional CA and antiarrhythmic drugs (P = 0.32).<h4>Conclusion</h4>During a centre's early experience, VATS ablation may have similar success rates to those from an established CA service, but carry a greater risk of major complications. Those embarking on a programme of VATS AF ablation should be aware that complication and success rates may differ from those reported by selected high-volume centres.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Atrial fibrillation, Catheter ablation, Surgical ablation, Minimally invasive, Thoracoscopic, Complications, Cohort study |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 02 Oct 2019 09:10 |
| Last Modified: | 19 Jan 2023 00:24 |
| DOI: | 10.1093/europace/euy303 |
| Open Access URL: | https://doi.org/10.1093/europace/euy303 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3056661 |
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