Suwalski Piotr, Suwalski Grzegorz, Wilimski Radosław, Kochanowski Janusz, Scisło Piotr, Gaca Hanna, Popiel Zbigniew, Sledź Mariusz, Smolarska-Switaj Julita, Suwalski Kazimierz
Department of Cardiac Surgery, Medical University, Warsaw, Poland.
Kardiol Pol. 2007 Apr;65(4):370-4; discussion 375-6.
Atrial fibrillation (AF) is the most common arrhythmia, having a strong impact on long-term stroke and heart failure prevalence and mortality. Nowadays, rapid development in the field of minimising the invasiveness of surgical ablation of AF can be observed.
To report on the feasibility and early results of the first Polish experience with a novel technique of minimally invasive video-assisted beating heart bilateral surgical ablation for lone paroxysmal AF using irrigated bipolar radiofrequency technique.
Between February and December 2006, 6 patients with highly symptomatic paroxysmal AF, resistant to pharmacological treatment, underwent video-assisted beating heart bilateral pulmonary vein isolation using irrigated bipolar radiofrequency combined with vein of Marshall dissection and left atrial appendage closure. In 2 patients at least 2 unsuccessful percutaenous ablations had previously been performed.
There were no complications. Ablation time was on average 88+/-12.1 seconds. At least one recurrence of AF was observed in 4 patients in the early postoperative period; in 3 of them an electrical cardioversion was performed. All patients were discharged home in stable sinus rhythm. Three patients have exceeded 3 months' observation; one has reached 6 months of observation. All are in stable sinus rhythm and the follow-up course is uneventful.
Minimally invasive video-assisted beating heart bilateral surgical ablation for lone paroxysmal AF using irrigated bipolar radiofrequency is effective and safe. These promising results have to be confirmed by larger studies.
心房颤动（AF）是最常见的心律失常，对长期中风、心力衰竭患病率及死亡率有重大影响。如今，在房颤手术消融微创化领域可观察到快速发展。
报告波兰首例使用灌注式双极射频技术对孤立性阵发性房颤进行微创视频辅助心脏跳动中双侧手术消融的新技术的可行性及早期结果。
2006年2月至12月期间，6例症状严重的阵发性房颤患者，药物治疗无效，接受了视频辅助心脏跳动中双侧肺静脉隔离术，采用灌注式双极射频结合Marshall静脉解剖及左心耳封闭术。其中2例患者此前至少进行过2次经皮消融但未成功。
无并发症发生。消融时间平均为88±12.1秒。术后早期4例患者出现至少1次房颤复发；其中3例进行了电复律。所有患者均以稳定的窦性心律出院回家。3例患者观察期超过3个月；1例达到6个月观察期。所有患者均处于稳定的窦性心律，随访过程顺利。
使用灌注式双极射频对孤立性阵发性房颤进行微创视频辅助心脏跳动中双侧手术消融是有效且安全的。这些有前景的结果有待更大规模研究证实。
