Koistinen Juhani, Valtonen Mika, Savola Jukka, Airaksinen Juhani
Department of Surgery, Turku University, Finland.
Interact Cardiovasc Thorac Surg. 2007 Dec;6(6):695-8. doi: 10.1510/icvts.2006.147942. Epub 2007 Aug 15.
The aim of the study was to assess the safety and efficacy of thoracoscopic microwave ablation in treating atrial fibrillation (AF). AF predisposes to embolic complications and may cause heart failure. The treatment of AF is still challenging in spite of the promising results of endocardial radiofrequency approach. The present study is a follow-up study of 22 patients (mean age 45 years, range 21-59) with disabling paroxysmal (n=10) or persistent (n=12) AF who underwent a thoracoscopic microwave isolation of pulmonary veins. The patients had a lone AF. All the patients had suffered from severely disabling AF for >1 year (range 1-16 years) without any response to antiarrhythmic medication. The patients have been followed-up on an average of 11 months (range 3-22 months). During the follow-up, 13 (60%) patients have become asymptomatic without any documentation of AF since at least two months, six (27%) patients with anti-arrhythmic medication have clinically improved. Because of major intrathoracic bleeding and because of liver damage the thoracoscopy wound had to be expanded to open thoracotomy in two patients. Thoracoscopic AF microwave ablation seems to be a promising alternative to endocardial ablation in the treatment of highly symptomatic paroxysmal and persistent AF.
本研究的目的是评估胸腔镜下微波消融治疗心房颤动（AF）的安全性和有效性。AF易引发栓塞并发症，并可能导致心力衰竭。尽管心内膜射频消融术取得了令人鼓舞的成果，但AF的治疗仍然具有挑战性。本研究是一项对22例（平均年龄45岁，范围21 - 59岁）患有致残性阵发性（n = 10）或持续性（n = 12）AF患者的随访研究，这些患者接受了胸腔镜下肺静脉微波隔离术。患者为孤立性AF。所有患者均患有严重致残性AF超过1年（范围1 - 16年），对抗心律失常药物无任何反应。患者平均随访了11个月（范围3 - 22个月）。在随访期间，13例（60%）患者至少两个月以来无症状且无AF记录，6例（27%）使用抗心律失常药物的患者临床症状有所改善。由于严重的胸腔内出血和肝损伤，两名患者的胸腔镜伤口不得不扩大为开胸手术。胸腔镜下AF微波消融术似乎是治疗高度症状性阵发性和持续性AF的一种有前景的心内膜消融替代方法。
