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Updated: Apr 3, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Stroke prevention following modified endoscopic ablation and appendectomy for atrial fibrillation
Nan Ma1, Zhaolei Jiang1, Fei Chen1
1Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kong Jiang Road, Shanghai, 200092, People's Republic of China.
Insights
This study shows a modified endoscopic procedure effectively prevents stroke in atrial fibrillation (AF) patients. The treatment restored normal heart rhythm in most patients, with no strokes observed during follow-up.
Area of Science:
- Cardiology
- Minimally Invasive Surgery
Background:
- Atrial fibrillation (AF) is a common arrhythmia associated with a high risk of stroke.
- Current treatments for AF-related stroke prevention have limitations.
Purpose of the Study:
- To evaluate the efficacy and safety of a modified endoscopic procedure for stroke prevention in patients with atrial fibrillation.
- To assess the procedure's impact on restoring sinus rhythm and preventing thromboembolic events.
Main Methods:
- 82 patients with paroxysmal, persistent, or long-standing AF underwent a modified endoscopic procedure.
- The procedure involved pulmonary vein isolation, left atrial ablation, and left atrial appendage (LAA) exclusion using a stapler on a beating heart.
- Post-procedure monitoring included brain CT, cardiac CT, and 24-h Holter monitoring.
Main Results:
- The procedure was successfully completed in all patients with a mean duration of 122 minutes.
- No transient ischemic attack or stroke events were reported during a mean follow-up of 24.3 months.
- 87.8% of patients achieved sinus rhythm, and cardiac CT confirmed LAA exclusion without thrombosis.
Conclusions:
- The modified endoscopic procedure is a safe and effective treatment for AF, restoring sinus rhythm.
- This minimally invasive approach shows potential for preventing AF-related strokes.
Abstract:
We reported the results of stroke prevention following modified endoscopic procedure for atrial fibrillation. 82 patients underwent modified endoscopic procedure for atrial fibrillation (AF), in whom 47 had paroxysmal, 28 had persistent, and 7 had long-standing atrial fibrillation. CHA2DS2VASC median score was 3 (range from 0 to 8). The procedure was performed on the beating heart, through 3 ports on the left chest wall. Pulmonary vein isolation and ablation of the left atrium were achieved by bipolar radiofrequency ablation. Left atrial appendage (LAA) was excluded by stapler. Brain CT, cardiac CT and 24-h Holter monitoring were performed following the procedure. The procedure was successfully completed for all patients. The mean duration was 122 ± 40.1 min. LAA was excluded after appendectomy and checked by intraoperative transesophageal echocardiography. The mean follow-up duration was 24.3 ± 3.5 months. No patients showed signs and symptoms of transient ischemic attack or stroke. No new positive findings were demonstrated by recurring brain CT scan performed after the procedure. Cardiac CT confirmed the absence of LAA and thrombosis in the left atrium. 87.8 % (72/82) of all patients were in sinus rhythm. Our results demonstrate that the modified endoscopic procedure is a safe, effective, and appropriate treatment for AF, which restores sinus rhythm and may be associated with the prevention of AF-related stroke.
