Related Experiment Video
Updated: Jun 27, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Toward a definitive, totally thoracoscopic procedure for atrial fibrillation
John Sirak1, Danielle Jones, Benjamin Sun
1Ohio State University Department of Surgery, Division of Cardiothoracic Surgery, Columbus, Ohio, USA.
Purpose:
Evolution of anti-arrhythmia surgery beyond the Cox maze III has been hampered by the difficulty in implementing a complete lesion set in a truly minimally invasive approach. In this study, we introduce a true port-access procedure that addresses both autonomic and anatomic sources of atrial fibrillation, with real-time verification of all technical endpoints.
Description:
A total of 32 patients with persistent or longstanding persistent atrial fibrillation underwent the totally thoracoscopic anti-arrhythmia procedure incorporating pulmonary vein isolation, mapping of epicardial autonomics, extended linear ablations across critical segments of atrial substrate, and ligation of the left atrial appendage. All aspects of the procedure were confirmed with intraoperative electrophysiologic testing.
Evaluation:
With 1 week of continuous rhythm surveillance at 3, 6, and 13 months postoperatively in all patients, 21 of 24 patients with 6-month follow-up are in sinus rhythm with no anti-arrhythmia medications.
Conclusions:
An anti-arrhythmia operation that is highly effective in patients with advanced forms of atrial fibrillation can be safely performed through a totally port-access approach.
