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Updated: Aug 28, 2025
Robotic Ablation of Atrial Fibrillation
Published on: May 29, 2015
Thoracoscopic epicardial ablation of atrial fibrillation: Safety, efficacy, single center experience
Martin Troubil1, Martin Simek1, Jan Juchelka1
1Department of Cardiac Surgery, University Hospital Olomouc, Czech Republic.
Insights
Thoracoscopic ablation for atrial fibrillation (AF) maintained sinus rhythm in 81% of patients after 3.1 years. While recurrence occurred, few patients required antiarrhythmic drugs, indicating a safe rhythm control strategy.
Area of Science:
- Cardiology
- Thoracic Surgery
- Electrophysiology
Background:
- Atrial fibrillation (AF) significantly impacts quality of life and increases stroke risk.
- Epicardial ablation offers a rhythm control strategy for drug-refractory or high-risk AF patients.
- Thoracoscopic ablation has emerged as a viable procedural approach.
Purpose of the Study:
- To evaluate the efficacy and safety of thoracoscopic ablation for atrial fibrillation at our institution.
- Assess long-term rhythm control outcomes and complication rates.
Main Methods:
- Retrospective observation of 81 patients undergoing thoracoscopic ablation from January 2015 to December 2019.
- Analysis of patient demographics, AF type, procedural success, and follow-up data.
- Evaluation of arrhythmia recurrence, need for further treatment, and major complications.
Main Results:
- Sinus rhythm was achieved in 81% of patients at a mean follow-up of 3.1 years.
- Freedom from atrial arrhythmia recurrence was 55.7%, with 19% requiring repeat radiofrequency ablation.
- Major complications occurred in 5.0% of patients; no correlation found between recurrence and patient factors like BMI or LVEF.
Conclusions:
- Thoracoscopic ablation is an effective and safe rhythm control strategy for various AF types.
- A significant majority of patients maintain sinus rhythm post-procedure.
- Low rates of antiarrhythmic drug use suggest procedural success in reducing AF burden.
Aims:
Atrial fibrillation (AF) is associated with reduced quality of life and increased risk of ischaemic cerebrovascular events. The left atrial epicardial ablation procedures have evolved towards a successful and safe rhythm control strategy for patients with symptomatic drug-refractory paroxysmal, persistent or post-ablation AF or with a high risk of catheter ablation failure. The aim was to evaluate the efficacy and safety of thoracoscopic ablation at our instituiton.
Methods:
We observed 81 patients undergoing thoracoscopic ablation from January 2015 to December 2019.
Results:
The mean age was 61.3±8.5 years and the average duration of AF was 3.1±2.6 years. The cohort consisted of 16.5% of paroxysmal AF, 36.7% persistent, and 46.8% of long-standing AF. The procedure was completed in 79 patients; during follow-up, 15 patients (19%) received radiofrequency ablation. Freedom from atrial arrhythmia recurrence was 55.7% after a follow-up (FUP) period of 3.1±1.4 years. At the follow-up visit, sinus rhythm was present in 81% of patients. No relationships between arrhythmia recurrence and BMI, LVEF, left atrial dimension, gender, and AF duration were found. Major complications were noticed in 4 patients (5.0%); 2 had peripheral embolisation, 2 patients were converted to a sternotomy. At the time of the FUP visit, 25.3% of patients were using antiarrhythmic and 74.7% were still using anticoagulants.
Conclusion:
In the majority of patients, sinus rhythm remained despite a considerable atrial tachycardia recurrence rate, with a relatively low percentage of patients on antiarrythmic drugs.
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