Time-related prevalence of postoperative atrial fibrillation after stand-alone minimally invasive radiofrequency ablation.

La Meir, Mark; Gelsomino, Sandro; Luca, Fabiana; Pison, Laurent; Chambille, Pol; Parise, Orlando; Crijns, Harry J; Maessen, Jos G

BACKGROUND AND AIM OF THE STUDY We present our results with minimally invasive surgical treatment of lone atrial fibrillation (LAF) employing a radiofrequency (RF) source through a bilateral thoracoscopy. METHODS Between January 2007 and January 2011, 28 consecutive patients (85.7% male, mean age 67.1 ± 9.1 years) with LAF underwent video-assisted bilateral RF ablation. Fourteen patients (50%) had paroxysmal, five (17.8%) persistent, and nine (32.2%) long-persistent LAF. All patients were followed-up according to the Heart Rhythm Society/ European Heart Rhythm Association/European Cardiac Arrhythmia Society (HRS/EHRA/ECA) and success/failure was reported as suggested by Society of Thoracic Surgeon (STS) guidelines. Mean follow-up was 27.8 ± 8.6 months. RESULTS Time-related prevalence of postoperative AF was 4.5% at 36 months. Success was much more likely in subjects with paroxysmal (3-year prevalence, 0%) or persistent (3-year prevalence, 0%) than long-standing persistent LAF (3-year prevalence, 8.3%). At 36 months the estimated prevalence of antiarrhythmic drugs was 11.3% (8.8 to 13.7). No major thromboembolic events were detected during the follow-up period and 36-month prevalence of Warfarin use was 15.2% (11.5 to 18.1). Finally, no patient underwent electrical cardioversion. CONCLUSIONS This approach yielded satisfactory results with a high degree of safety. Further larger studies are necessary to confirm our findings.