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Position of Totally Thoracoscopic Surgical Ablation in the Treatment of Atrial Fibrillation: An Alternative Method of Conduction Testing

Anton Sabashnikov, Alexander Weymann, Shouvik Haldar, Rafik F.B. Soliman, Javid Fatullayev, David Jones, Wajid Hussain, Yeong-Hoon Choi, Mohamed Zeriouh, Pascal M. Dohmen, Aron-Frederik Popov, Vias Markides, Tom Wong, Toufan Bahrami

Department of Cardiothoracic Surgery, Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, Harefield, United Kingdom

Med Sci Monit Basic Res 2015; 21:76-80

DOI: 10.12659/MSMBR.894239

Available online: 2015-04-23

Published: 2015-04-23


ABSTRACT: Recent advances in surgical techniques and understanding of the pathophysiology of atrial fibrillation has led to the development of a less invasive thoracoscopic surgical treatment including video-assisted bilateral pulmonary vein isolation using bipolar radiofrequency ablation clamps. More recently, the same operation became possible via a totally thoracoscopic approach.
In this paper we describe technical aspects of the thoracoscopic approach to surgical treatment of AF and discuss its features, benefits and limitations. Furthermore, we present a new alternative technique of conduction testing using endoscopic multi-electrode recording catheters.
An alternative electrophysiological mapping strategy involves a multi-electrode recording catheter designed primarily for percutaneous endocardial electrophysiologic mapping procedure. According to our initial experience, the recordings obtained from the multi-electrode catheters positioned around the pulmonary veins are more accurate than the recordings obtained from the multifunctional ablation and pacing pen.
The totally thoracoscopic surgical ablation approach is a feasible and efficient treatment strategy for atrial fibrillation. The conduction testing can be easily and rapidly performed using a multifunctional pen or multi-electrode recording catheter.

Keywords: Cardiac Catheters - trends, Atrial Fibrillation - surgery, Catheter Ablation - methods, Heart Conduction System - physiopathology, Thoracoscopy - trends