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KMID : 1011920230240010023
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International Journal of Arrhythmia
2023 Volume.24 No. 1 p.23 ~ p.23
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The effect of empirical superior vena cava isolation during total thoracoscopic ablation in patients with persistent atrial fibrillation
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Kwon Hee-Jin
Jeong Dong-Seop
Park Seung-Jung
Park Kyoung-Min
Kim June-Soo
On Young-Keun
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Abstract
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Background : In patients with non-paroxysmal AF (atrial fibrillation), various ablation strategies have been attempted to target non-pulmonary vein (PV) foci or to achieve substrate modification beyond pulmonary vein isolation. The efficacy of empirical ablation of the SVC, one of the most common non-PV foci, is unclear. The aim of this study was to investigate the efficacy and safety of additional superior vena cava (SVC) isolation in patients with non-paroxysmal AF undergoing thoracoscopic surgical ablation.
Methods/results : A total of 191 patients with persistent or long-standing persistent AF was enrolled. All patients underwent total thoracoscopic surgical ablation for AF, and half of them also received empirical SVC isolation. We compared the atrial tachyarrhythmia (ATa)-free survival rate and procedure-related complications in the two groups of patients. The 3-year ATa-free survival rate was 53% in the SVC isolation group and 52% in the no-SVC isolation group (p?=?0.644). There were no differences between the two groups with respect to AF type or LA size. Procedure-related complications occurred in 12 patients (6%). Pacemakers were implanted only in three patients from the SVC isolation group. The only factor influencing recurrence of ATa was LA diameter.
Conclusions : Empirical SVC isolation during thoracoscopic ablation for persistent AF did not improve patient outcomes.
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KEYWORD
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Persistent atrial fbrillation, Thoracoscopic surgical ablation, Superior vena cava, Empirical isolation, Non-PV trigger
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