Sabashnikov Anton, Weymann Alexander, Haldar Shouvik, Soliman Rafik F B, Fatullayev Javid, Jones David, Hussain Wajid, Choi Yeong-Hoon, Zeriouh Mohamed, Dohmen Pascal M, Popov Aron-Frederik, Markides Vias, Wong Tom, Bahrami Toufan
Department of Cardiothoracic Surgery, Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, Harefield, United Kingdom.
Department of Cardiology, Royal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, London, United Kingdom.
Med Sci Monit Basic Res. 2015 Apr 23;21:76-80. doi: 10.12659/MSMBR.894239.
Recent advances in surgical techniques and understanding of the pathophysiology of atrial fibrillation has led to the development of a less invasive thoracoscopic surgical treatment including video-assisted bilateral pulmonary vein isolation using bipolar radiofrequency ablation clamps. More recently, the same operation became possible via a totally thoracoscopic approach. In this paper we describe technical aspects of the thoracoscopic approach to surgical treatment of AF and discuss its features, benefits and limitations. Furthermore, we present a new alternative technique of conduction testing using endoscopic multi-electrode recording catheters. An alternative electrophysiological mapping strategy involves a multi-electrode recording catheter designed primarily for percutaneous endocardial electrophysiologic mapping procedure. According to our initial experience, the recordings obtained from the multi-electrode catheters positioned around the pulmonary veins are more accurate than the recordings obtained from the multifunctional ablation and pacing pen. The totally thoracoscopic surgical ablation approach is a feasible and efficient treatment strategy for atrial fibrillation. The conduction testing can be easily and rapidly performed using a multifunctional pen or multi-electrode recording catheter.
外科技术的最新进展以及对心房颤动病理生理学的认识，促使了一种侵入性较小的胸腔镜手术治疗方法的发展，包括使用双极射频消融钳进行视频辅助双侧肺静脉隔离。最近，通过完全胸腔镜手术方法也可以进行同样的手术。在本文中，我们描述了胸腔镜手术治疗房颤的技术要点，并讨论了其特点、优势和局限性。此外，我们还介绍了一种使用内镜多电极记录导管进行传导测试的新替代技术。一种替代的电生理标测策略涉及一种主要为经皮心内膜电生理标测程序设计的多电极记录导管。根据我们的初步经验，从置于肺静脉周围的多电极导管获得的记录比从多功能消融和起搏笔获得的记录更准确。完全胸腔镜手术消融方法是一种可行且有效的房颤治疗策略。使用多功能笔或多电极记录导管可以轻松、快速地进行传导测试。
