In-hospital results of thoracoscopic box-lesion radiofrequency left atrial ablation for atrial fibrillation

Objective. To analyze own experience of thoracoscopic box-lesion radiofrequency left atrial ablation for atrial fibrillation (AF). Material and methods. We present in-hospital results of thoracoscopic box-lesion radiofrequency ablation of the left atrium in 28 patients with AF between 2022 and 2023. Results. All patients had sinus rhythm at discharge. There were no cases of permanent pacemaker implantation. Hospital-stay was 11.6±6.5 days. Postoperative paroxysms of AF occurred in 4 (14.3%) patients, paroxysms of atypical atrial flutter — in 8 (28.6%) patients. Electrical cardioversion was performed in 8 (28.6%) patients with paroxysms of AF / atrial flutter. These rhythm disturbances in early postoperative period were observed in patients with non-paroxysmal baseline form of arrhythmia. A serious complication at the stage of mastering this technique occurred in one patient (damage to the esophagus). Conclusion. Thoracoscopic box-lesion radiofrequency left atrial ablation is highly effective despite duration, form of atrial fibrillation and left atrium enlargement. Safety of this procedure depends on surgical experience with minimal risk of surgical complications beyond the «learning curve».