Impact of Thoracoscopic Pulmonary Vein Isolation on Right Ventricular Function: A Pilot Study

Area of Science:

• Cardiology
• Cardiac Electrophysiology
• Thoracic Surgery

Background:

• Thoracoscopic surgical pulmonary vein isolation (sPVI) is an effective treatment for atrial fibrillation (AF).
• Right ventricular (RV) function after sPVI has not been previously investigated.
• Understanding RV function post-sPVI is crucial for comprehensive patient care.

Purpose of the Study:

• To evaluate changes in RV function following sPVI.
• To compare RV function post-sPVI with RV function after endocardial cryoballoon pulmonary vein isolation (PVI).

Main Methods:

• A prospective study involving 25 patients undergoing sPVI and 21 matched controls undergoing cryoballoon PVI.
• RV function assessed using tricuspid annular plane systolic excursion (TAPSE) and 2D speckle tracking RV strain.
• Echocardiography performed at baseline and 6-month follow-up.

Main Results:

• sPVI significantly reduced TAPSE by 31% (p < 0.001) and RV strain by 25% (p = 0.018) at follow-up.
• No significant changes in TAPSE or RV strain were observed in the cryoballoon PVI group.
• Significant differences in changes of TAPSE and RV strain were noted between the sPVI and cryoballoon PVI groups (p ≤ 0.001 and p = 0.005).

Conclusions:

• sPVI leads to a significant decrease in RV function.
• Cryoballoon PVI did not demonstrate a similar negative impact on RV function.
• Further research is warranted to understand the mechanisms and clinical implications of RV dysfunction post-sPVI.