Progress of Treatment of Non-valvular Atrial Fibrillation by Minimally Invasive Surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIUXin-yu ,  LIUHong-yu

Department of Cardiac Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150010, P. R. China;

Corresponding author：

LIUHong-yu, Email: hyliu1963@163.com

Keywords：

Minimally invasive surgical; Hybrid surgical; Non-valvular atrial fibrillation

DOI：

10.7507/1007-4848.20150196

Video：

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Abstract Full text Figures/Tables Video References Cited by

Non-valvular atrial fibrillation has a high morbidity. Cox Ⅲ surgery is the gold standard for treating all kinds of atrial fibrillation. However, which needs to be performed with cardiopulmonary bypass (CPB) and the trauma caused by it is severe. It is placed emphasis on minimal invasion, safety and efficacy for contemporary surgery so as to minimally invasive intervention is important in the treating non-valvular atrial fibrillation. Although the results of epicardial ablation with video-assisted thoracoscopic surgery (VATS) are better than that of transcatheter ablation, it also has some disadvantages and shortages under certain circumstance. Epicardial ablation with VATS combined with transcatheter ablation is complemantary which becomes the hot spot for treatment of novalvular atrial fibrillation.

Citation： LIUXin-yu, LIUHong-yu. Progress of Treatment of Non-valvular Atrial Fibrillation by Minimally Invasive Surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(8): 783-787. doi: 10.7507/1007-4848.20150196 Copy

1.	January CT, Wann ST, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society:Executive summary. Circulation, 2014, 130(23):2071-2104.
2.	January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation:A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol, 2014, 7(14):1740-1749.
3.	Cox JG, Canavan TE, Schuessler RB, et al. The surgical treatment of atrial fibrillation. Ⅱ. Intraoperative electrophysiologic mapping and description of the electrophysiologic basis of atrial flutter and atrial fibrillation. J Thorac Cardiovasc Surg, 1991, 101(3):406-426.
4.	Wit AL, Allessie MA, Bonke FI, et al. Electrophysiologic mapping to determine the mechanism of experimental ventricular tachycardia initiated by premature impulses. Experimental approach and initial results demonstrating reentrant excitation. Am J Cardiol, 1982, 49(1):166-185.
5.	Cox JL, Schuessler RB, Boineau JP. The surgical treatment of atrial fibrillation.Ⅰ. Summary of current concepts of the mechanism of atrial flutter and atrial fibrillation. J Thorac Cardiovasc Surg, 1991, 101(3):402-405.
6.	Falk RH. Atrial fibrillation. N Engl J Med, 2001, 344(14):1067-1078.
7.	Nattel S. New ideas about atrial fibrillation 50 years on. Nature, 2002, 415(6868):219-226.
8.	Ho SY, Anderson RH, Sánchez-Quintana D. Atrial structures and fibres:morphological bases of atrial conduction. J Cardiovasc Res, 2002, 54(2):325-336.
9.	Chen YJ, Chen SA. Electrophysiology of pulmonary veins. J Cardiovasc Electrophysiol, 2006, 17(2):220-224.
10.	Haïssaguerre M, Jaïs P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med, 1998, 339(10):659-666.
11.	Nathan H, Eliakim M. The junction between the left atrium and the pulmonary veins:an anatomic study of the human hearts. Circulation, 1966, 34(3):412-422.
12.	Patterson E, Po SS, Scherlag BJ, et al. Triggered firing in pulmonary veins initiated by in vitro autonomic nerve stimulation. Heart Rhythm, 2005, 2(6):624-631.
13.	Schauerte P, Scherlag BJ, Patterson E, et al. Focal atrial fibrillation:experimental evidence for a pathophysiologic role of the autonomic nervous system. J Cardiovasc Electrophysiol, 2001, 12(5):592-599.
14.	Chen PS, Tan AY. Autonomic nerve activity and atrial fibrillation. Heart Rhythm, 2007, 4(3 Suppl):S61-S64.
15.	Coumel P. Autonomic influences in atrial tachyarrhythmias. J Cardiovasc Electrophysiol, 1996, 7(10):999-1007.
16.	Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg, 1996, 61(2):755-759.
17.	Di Biase L, Burkhardt JD, Mohanty P, et al. Left atrial appendage:an underrecognized trigger site of atrial fibrillation. Circulation, 2010, 122(2):109-118.
18.	Calkins H, kuck kH, Cappato R, et al. 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation:recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Europace, 2012, 14(4):528-606.
19.	Randall k. Wolf, Sandra Burgess. Minimally invasive surgery for atrial fibrillation-Wolf Mini Maze procedure. Ann Cardiothorac Surg, 2014, 3(1):122-123.
20.	Beyer E, Lee R, Lam Bk. Point:Minimally invasive bipolar radiofrequency ablation of lone atrial fibrillation:early multicenter results. J Thorac Cardiovasc Surg, 2009, 137(3):521-526.
21.	Sawhney N, Anousheh R, Chen W, et al. Circumferential pulmonary vein ablation with additional linear ablation results in an increased incidence of left atrial flutter compared with segmental pulmonary vein isolation as an initial approach to ablation of paroxysmal atrial fibrillation. Circ Arrhythmia Electrophysiol, 2010, 3(3):243-248.
22.	Yamada T, Murakami Y, Okada T, et al. Electrophysiological pulmonary vein antrum isolation with a multielectrode basket catheter is feasible and effective for curing paroxysmal atrial fibrillation:efficacy of minimally extensive pulmonary vein isolation. Heart Rhythm, 2006, 3(4):377-384.
23.	Holmes DR, Reddy VY, Turi ZG, et al. Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation:a randomised noninferiority trial. Lancet, 2009, 374(9689):534-542.
24.	Boersma LV, Castella M, van Boven W, et al. Atrial fibrillation catheter ablation versus surgical ablation treatment (FAST):a 2-center randomized clinical trial. Circulation, 2012, 125(1):23-30.
25.	Nitta T, Ishii Y, Miyagi Y, et al. Concurrent multiple left atrial focal activations with fibrillatory conduction and right atrial focal or reentrant activation as the mechanism in atrial fibrillation. J Thorac Cardiovasc Surg, 2004, 127(3):770-778.
26.	Zeng Y, Cui Y, Li Y, et al. Recurrent atrial arrhythmia after minimally invasive pulmonary vein isolation for atrial fibrillation. Ann Thorac Surg, 2010, 90(2):510-515.
27.	Pison L, La Meir M, van Opsal J, et al. Hybrid thoracoscopic surgical and transvenous catheter ablation of atrial fibrillation. J Am Coll Cardiol, 2012, 60(1):54-61.
28.	Cox JL, Ad N. The importance of cryoablation of the coronary sinus during the Maze procedure. Semin Thorac Cardiovasc Surg, 2000, 12(1):20-24.
29.	Zheng S, Li Y, Han J, et al. Long-term results of a minimally invasive surgical pulmonary vein isolation and ganglionic plexi ablation for atrial fibrillation. PLoS ONE, 2013, 8(11):e79755.
30.	Takigawa M, Yamada T, Yoshida Y, et al. Patterns of Pulmonary vein potential disappearance during encircling ipsilateral pulmonary vein isolation can predict eecurrence of atrial fibrillation. Circ J, 2014, 78(3):601-609.
31.	kron J, kasirajan V, Wood MA, et al. Management of recurrent atrial arrhythmias after minimally invasive surgical pulmonary vein isolation and ganglionic plexi ablation for atrial fibrillation. Heart Rhythm, 2010, 7(4):445-451.
32.	Lee AM, Aziz A, Clark kL, et al. Chronic performance of a novel radiofrequency ablation device on the beating heart:Limitations of conduction delay to assess transmurality. J Thorac Cardiovasc Surg, 2012, 144(4):859-865.
33.	Gelsomino S, Van Breugel HN, Pison L, et al. Hybrid thoracoscopic and transvenous catheter ablation of atrial fibrillation. Eur J Cardiothorac Surg, 2014, 45(3):401-407.
34.	Mahapatra S, LaPar DJ, kamath S, et al. Initial experience of sequential surgical epicardial-catheter endocardial ablation for persistent and long-standing persistent atrial fibrillation with long-term follow-up. Ann Thorac Surg, 2011, 91(6):1890-1898.
35.	Muneretto C, Bisleri G, Bontempi L, et al. Durable staged hybrid ablation with thoracoscopic and percutaneous approach for treatment of long-standing atrial fibrillation:a 30-month assessment with continuous monitoring. J Thorac Cardiovasc Surg, 2012, 144(6):1460-1465.
36.	Bisleri G, Rosati F, Bontempi L, et al. Hybrid approach for the treatment of long-standing persistent atrial fibrillation:electrophysiological findings and clinical results. Eur J Cardiothorac Surg, 2013, 44(5):919-923.
37.	La Meir M, Gelsomino S, Lorusso R, et al. The hybrid approach for the surgical treatment of lone atrial fibrillation:one-year results employing a monopolar radiofrequency source. J Cardiothorac Surg, 2012, 7:71.
38.	La Meir M, Gelsomino S, Lucà F, et al. Minimally invasive surgical treatment of lone atrial fibrillation:Early results of hybrid versus standard minimally invasive approach employing radiofrequency sources. Int J Cardiol, 2013, 167(4):1469-1475.
39.	krul SP, Driessen AH, van Boven WJ, et al. Thoracoscopic videoassisted pulmonary vein antrum isolation, ganglionated plexus ablation, and periprocedural confirmation of ablation lesions:first results of a hybrid surgical-electrophysiological approach for atrial fibrillation. Circ Arrhythm Electrophysiol, 2011, 4(3):262-270.
40.	La Meir M. Surgical options for treatment of atrial fibrillation. Ann Cardiothorac Surg, 2014, 3(1):30-37.
41.	Bisleri G, Muneretto C. eComment. Hybrid treatment of lonestanding atrial fibrillation. Interact Cardiovasc Thorac Surg, 2012, 14(4):451.
42.	Magnano AR, Argenziano M, Dizon JM, et al. Mechanisms of atrial tachyarrhythmias following surgical atrial fibrillation ablation. J Cardiovasc Electrophysiol, 2006, 17(4):366-373.
43.	Zhou Q, Hou Y, Yang S. A meta-analysis of the comparative efficacy of ablation for atrial fibrillation with and without ablation of the ganglionated plexi. Pacing Clin Electrophysiol, 2011, 34(12):1687-1694.
44.	Zhang Y, Wang Z, Wang W, et al. Efficacy of cardiac autonomic denervation for atrial fibrillation:a meta-analysis. J Cardiovasc Electrophysiol, 2012, 23(6):592-600.
45.	Verma A, Cairns JA, Mitchell LB,et al. 2014 Focused Update of the Canadian Cardiovascular Society Guidelines for the Management of Atrial Fibrillation. Can J Cardiol, 2014, 30(10):1114-1130.
46.	Turi ZG. The assault on the left atrial appendage in perspective. J Am Coll Cardiol, 2013, 62(2):119-120.
47.	Gerstenfeld EP, Callans DJ, Dixit S, et al. Incidence and location of focal atrial fibrillation triggers in patients undergoing repeat pulmonary vein isolation:implications for ablation strategies. J Cardiovasc Electrophysiol, 2003, 14(7):685-690.

1. January CT, Wann ST, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society:Executive summary. Circulation, 2014, 130(23):2071-2104.
2. January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation:A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol, 2014, 7(14):1740-1749.
3. Cox JG, Canavan TE, Schuessler RB, et al. The surgical treatment of atrial fibrillation. Ⅱ. Intraoperative electrophysiologic mapping and description of the electrophysiologic basis of atrial flutter and atrial fibrillation. J Thorac Cardiovasc Surg, 1991, 101(3):406-426.
4. Wit AL, Allessie MA, Bonke FI, et al. Electrophysiologic mapping to determine the mechanism of experimental ventricular tachycardia initiated by premature impulses. Experimental approach and initial results demonstrating reentrant excitation. Am J Cardiol, 1982, 49(1):166-185.
5. Cox JL, Schuessler RB, Boineau JP. The surgical treatment of atrial fibrillation.Ⅰ. Summary of current concepts of the mechanism of atrial flutter and atrial fibrillation. J Thorac Cardiovasc Surg, 1991, 101(3):402-405.
6. Falk RH. Atrial fibrillation. N Engl J Med, 2001, 344(14):1067-1078.
7. Nattel S. New ideas about atrial fibrillation 50 years on. Nature, 2002, 415(6868):219-226.
8. Ho SY, Anderson RH, Sánchez-Quintana D. Atrial structures and fibres:morphological bases of atrial conduction. J Cardiovasc Res, 2002, 54(2):325-336.
9. Chen YJ, Chen SA. Electrophysiology of pulmonary veins. J Cardiovasc Electrophysiol, 2006, 17(2):220-224.
10. Haïssaguerre M, Jaïs P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med, 1998, 339(10):659-666.
11. Nathan H, Eliakim M. The junction between the left atrium and the pulmonary veins:an anatomic study of the human hearts. Circulation, 1966, 34(3):412-422.
12. Patterson E, Po SS, Scherlag BJ, et al. Triggered firing in pulmonary veins initiated by in vitro autonomic nerve stimulation. Heart Rhythm, 2005, 2(6):624-631.
13. Schauerte P, Scherlag BJ, Patterson E, et al. Focal atrial fibrillation:experimental evidence for a pathophysiologic role of the autonomic nervous system. J Cardiovasc Electrophysiol, 2001, 12(5):592-599.
14. Chen PS, Tan AY. Autonomic nerve activity and atrial fibrillation. Heart Rhythm, 2007, 4(3 Suppl):S61-S64.
15. Coumel P. Autonomic influences in atrial tachyarrhythmias. J Cardiovasc Electrophysiol, 1996, 7(10):999-1007.
16. Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg, 1996, 61(2):755-759.
17. Di Biase L, Burkhardt JD, Mohanty P, et al. Left atrial appendage:an underrecognized trigger site of atrial fibrillation. Circulation, 2010, 122(2):109-118.
18. Calkins H, kuck kH, Cappato R, et al. 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation:recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Europace, 2012, 14(4):528-606.
19. Randall k. Wolf, Sandra Burgess. Minimally invasive surgery for atrial fibrillation-Wolf Mini Maze procedure. Ann Cardiothorac Surg, 2014, 3(1):122-123.
20. Beyer E, Lee R, Lam Bk. Point:Minimally invasive bipolar radiofrequency ablation of lone atrial fibrillation:early multicenter results. J Thorac Cardiovasc Surg, 2009, 137(3):521-526.
21. Sawhney N, Anousheh R, Chen W, et al. Circumferential pulmonary vein ablation with additional linear ablation results in an increased incidence of left atrial flutter compared with segmental pulmonary vein isolation as an initial approach to ablation of paroxysmal atrial fibrillation. Circ Arrhythmia Electrophysiol, 2010, 3(3):243-248.
22. Yamada T, Murakami Y, Okada T, et al. Electrophysiological pulmonary vein antrum isolation with a multielectrode basket catheter is feasible and effective for curing paroxysmal atrial fibrillation:efficacy of minimally extensive pulmonary vein isolation. Heart Rhythm, 2006, 3(4):377-384.
23. Holmes DR, Reddy VY, Turi ZG, et al. Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation:a randomised noninferiority trial. Lancet, 2009, 374(9689):534-542.
24. Boersma LV, Castella M, van Boven W, et al. Atrial fibrillation catheter ablation versus surgical ablation treatment (FAST):a 2-center randomized clinical trial. Circulation, 2012, 125(1):23-30.
25. Nitta T, Ishii Y, Miyagi Y, et al. Concurrent multiple left atrial focal activations with fibrillatory conduction and right atrial focal or reentrant activation as the mechanism in atrial fibrillation. J Thorac Cardiovasc Surg, 2004, 127(3):770-778.
26. Zeng Y, Cui Y, Li Y, et al. Recurrent atrial arrhythmia after minimally invasive pulmonary vein isolation for atrial fibrillation. Ann Thorac Surg, 2010, 90(2):510-515.
27. Pison L, La Meir M, van Opsal J, et al. Hybrid thoracoscopic surgical and transvenous catheter ablation of atrial fibrillation. J Am Coll Cardiol, 2012, 60(1):54-61.
28. Cox JL, Ad N. The importance of cryoablation of the coronary sinus during the Maze procedure. Semin Thorac Cardiovasc Surg, 2000, 12(1):20-24.
29. Zheng S, Li Y, Han J, et al. Long-term results of a minimally invasive surgical pulmonary vein isolation and ganglionic plexi ablation for atrial fibrillation. PLoS ONE, 2013, 8(11):e79755.
30. Takigawa M, Yamada T, Yoshida Y, et al. Patterns of Pulmonary vein potential disappearance during encircling ipsilateral pulmonary vein isolation can predict eecurrence of atrial fibrillation. Circ J, 2014, 78(3):601-609.
31. kron J, kasirajan V, Wood MA, et al. Management of recurrent atrial arrhythmias after minimally invasive surgical pulmonary vein isolation and ganglionic plexi ablation for atrial fibrillation. Heart Rhythm, 2010, 7(4):445-451.
32. Lee AM, Aziz A, Clark kL, et al. Chronic performance of a novel radiofrequency ablation device on the beating heart:Limitations of conduction delay to assess transmurality. J Thorac Cardiovasc Surg, 2012, 144(4):859-865.
33. Gelsomino S, Van Breugel HN, Pison L, et al. Hybrid thoracoscopic and transvenous catheter ablation of atrial fibrillation. Eur J Cardiothorac Surg, 2014, 45(3):401-407.
34. Mahapatra S, LaPar DJ, kamath S, et al. Initial experience of sequential surgical epicardial-catheter endocardial ablation for persistent and long-standing persistent atrial fibrillation with long-term follow-up. Ann Thorac Surg, 2011, 91(6):1890-1898.
35. Muneretto C, Bisleri G, Bontempi L, et al. Durable staged hybrid ablation with thoracoscopic and percutaneous approach for treatment of long-standing atrial fibrillation:a 30-month assessment with continuous monitoring. J Thorac Cardiovasc Surg, 2012, 144(6):1460-1465.
36. Bisleri G, Rosati F, Bontempi L, et al. Hybrid approach for the treatment of long-standing persistent atrial fibrillation:electrophysiological findings and clinical results. Eur J Cardiothorac Surg, 2013, 44(5):919-923.
37. La Meir M, Gelsomino S, Lorusso R, et al. The hybrid approach for the surgical treatment of lone atrial fibrillation:one-year results employing a monopolar radiofrequency source. J Cardiothorac Surg, 2012, 7:71.
38. La Meir M, Gelsomino S, Lucà F, et al. Minimally invasive surgical treatment of lone atrial fibrillation:Early results of hybrid versus standard minimally invasive approach employing radiofrequency sources. Int J Cardiol, 2013, 167(4):1469-1475.
39. krul SP, Driessen AH, van Boven WJ, et al. Thoracoscopic videoassisted pulmonary vein antrum isolation, ganglionated plexus ablation, and periprocedural confirmation of ablation lesions:first results of a hybrid surgical-electrophysiological approach for atrial fibrillation. Circ Arrhythm Electrophysiol, 2011, 4(3):262-270.
40. La Meir M. Surgical options for treatment of atrial fibrillation. Ann Cardiothorac Surg, 2014, 3(1):30-37.
41. Bisleri G, Muneretto C. eComment. Hybrid treatment of lonestanding atrial fibrillation. Interact Cardiovasc Thorac Surg, 2012, 14(4):451.
42. Magnano AR, Argenziano M, Dizon JM, et al. Mechanisms of atrial tachyarrhythmias following surgical atrial fibrillation ablation. J Cardiovasc Electrophysiol, 2006, 17(4):366-373.
43. Zhou Q, Hou Y, Yang S. A meta-analysis of the comparative efficacy of ablation for atrial fibrillation with and without ablation of the ganglionated plexi. Pacing Clin Electrophysiol, 2011, 34(12):1687-1694.
44. Zhang Y, Wang Z, Wang W, et al. Efficacy of cardiac autonomic denervation for atrial fibrillation:a meta-analysis. J Cardiovasc Electrophysiol, 2012, 23(6):592-600.
45. Verma A, Cairns JA, Mitchell LB,et al. 2014 Focused Update of the Canadian Cardiovascular Society Guidelines for the Management of Atrial Fibrillation. Can J Cardiol, 2014, 30(10):1114-1130.
46. Turi ZG. The assault on the left atrial appendage in perspective. J Am Coll Cardiol, 2013, 62(2):119-120.
47. Gerstenfeld EP, Callans DJ, Dixit S, et al. Incidence and location of focal atrial fibrillation triggers in patients undergoing repeat pulmonary vein isolation:implications for ablation strategies. J Cardiovasc Electrophysiol, 2003, 14(7):685-690.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Progress of Treatment of Non-valvular Atrial Fibrillation by Minimally Invasive Surgery

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