Right mini-thoracotomy for left maze with transesophageal echo guidance

Area of Science:

• Cardiology
• Minimally Invasive Surgery
• Medical Devices

Background:

• Atrial fibrillation (AF) ablation is advancing with minimally invasive surgery (MIS) techniques.
• New instrumentation and surgical expertise enable epicardial ablation on beating hearts, reducing risks and improving recovery.

Purpose of the Study:

• To describe the use of the Epicor low profile (LP) system with high-intensity focused ultrasound (HIFU) for AF ablation via MIS.
• To evaluate the safety and efficacy of this novel approach guided by transesophageal echocardiography (TEE).

Main Methods:

• Ten patients underwent monolateral small thoracotomy for epicardial ablation.
• HIFU was used to create an epicardial box lesion around pulmonary veins and the mitral isthmus.
• TEE guided the ablation device positioning on the mitral isthmus.

Main Results:

• No mortalities or major complications, including pacemaker implantation, were observed.
• One patient experienced transient atrial tachycardia, and three had temporary AF requiring cardioversion.
• All patients achieved normal sinus rhythm during the follow-up period.

Conclusions:

• The Epicor LP system using HIFU is a safe and effective option for AF ablation.
• This single right minimally invasive approach offers a promising alternative for AF treatment.