Key result
The totally thoracoscopic surgical ablation approach is a feasible and efficient treatment strategy for atrial fibrillation, with conduction testing easily performed using a multi-electrode catheter.
Endoscopic multi-electrode recording catheters provide a feasible and potentially more accurate alternative for conduction testing during totally thoracoscopic surgical ablation for atrial fibrillation.
Supports feasibility of multi-electrode conduction testing in thoracoscopic AF ablation; leaves open need for randomized validation before practice change.
Recent advances in surgical techniques and understanding of the pathophysiology of atrial fibrillation has led to the development of a less invasive thoracoscopic surgical treatment including video-assisted bilateral pulmonary vein isolation using bipolar radiofrequency ablation clamps. More recently, the same operation became possible via a totally thoracoscopic approach. In this paper we describe technical aspects of the thoracoscopic approach to surgical treatment of AF and discuss its features, benefits and limitations. Furthermore, we present a new alternative technique of conduction testing using endoscopic multi-electrode recording catheters. An alternative electrophysiological mapping strategy involves a multi-electrode recording catheter designed primarily for percutaneous endocardial electrophysiologic mapping procedure. According to our initial experience, the recordings obtained from the multi-electrode catheters positioned around the pulmonary veins are more accurate than the recordings obtained from the multifunctional ablation and pacing pen. The totally thoracoscopic surgical ablation approach is a feasible and efficient treatment strategy for atrial fibrillation. The conduction testing can be easily and rapidly performed using a multifunctional pen or multi-electrode recording catheter.
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Sabashnikov et al. (2015) conducted a review in Atrial Fibrillation. Totally thoracoscopic surgical ablation and multi-electrode recording catheter was evaluated. The totally thoracoscopic surgical ablation approach is a feasible and efficient treatment strategy for atrial fibrillation, with conduction testing easily performed using a multi-electrode catheter.
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