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Minimally invasive pulmonary vein isolation and partial autonomic denervation for surgical treatment of atrial fibrillation

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Objective

It was our goal to determine the efficacy of a minimally invasive surgical approach to the treatment of atrial fibrillation that combines pulmonary vein antral isolation with targeted partial autonomic denervation.

Methods

Eighty-three patients underwent video-assisted bilateral pulmonary vein antral electrical isolation with confirmation of block and partial autonomic denervation. Sixty-two (41 paroxysmal, 21 persistent/long-standing persistent) patients had a follow-up of 6 months or greater. Fifty-seven of these patients had a long-term rhythm monitor at 6 months (39 paroxysmal, 18 persistent/long-standing persistent).

Results

Success was defined as no episodes of atrial fibrillation greater than 15 s duration on long-term monitoring. Treatment was successful in 32 of 39 (82.1%) patients with paroxysmal atrial fibrillation and 10 of 18 (55.6%) with persistent/long-standing persistent atrial fibrillation.

Conclusion

Early data suggest that pulmonary vein electrical isolation combined with targeted partial autonomic denervation is a safe and efficacious approach for the treatment of paroxysmal atrial fibrillation. Techniques are being developed for the minimally invasive surgical treatment of persistent and long-standing persistent atrial fibrillation from an epicardial approach.

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Authors and Affiliations

  1. Cardiopulmonary Research Science and Technology Institute (CRSTI), Dallas, TX, USA

    James R. Edgerton & Michael J. Mack

  2. University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    Warren M. Jackman

  3. 4708 Alliance Blvd., Suite 700, Plano, TX, 75093, USA

    James R. Edgerton

Authors
  1. James R. Edgerton
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  2. Warren M. Jackman
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  3. Michael J. Mack
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Correspondence to James R. Edgerton.

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Edgerton, J.R., Jackman, W.M. & Mack, M.J. Minimally invasive pulmonary vein isolation and partial autonomic denervation for surgical treatment of atrial fibrillation. J Interv Card Electrophysiol 20, 89–93 (2007). https://doi.org/10.1007/s10840-007-9177-y

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  • DOI: https://doi.org/10.1007/s10840-007-9177-y

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