Complete thoracoscopic ablation of the left atrium via the left chest for treatment of lone atrial fibrillation

Objective We developed a new thoracoscopic ablation procedure for lone atrial fibrillation (AF) based on new endoscopic technology and the adoption of new types of energy. Methods Fifty-five patients with lone atrial fibrillation underwent this therapy. Patient age ranged from 30 to 81 years and there were 39 men and 16 women. Of these patients, 38 had paroxysmal atrial fibrillation, 14 had persistent atrial fibrillation, and 3 had longstanding atrial fibrillation. The procedure was performed on the beating heart through 3 ports in the left chest wall. Pulmonary vein isolation and ablation of the left atrium were achieved by bipolar radiofrequency ablation. Ganglionic plexus ablation was completed using the ablation pen. The left atrial appendage was excluded. Results Mean procedure duration was 106.6 ± 42.8 minutes. No conversion to sternotomy or pacemaker implantation occurred and no patients died. Their hospital stay was 5.3 ± 2.0 days with a mean follow-up of 12.6 ± 2.2 months. Forty-nine of 55 patients (89.1%) patients were in sinus rhythm. Six patients could not maintain sinus rhythm. Thrombus in the left atrium and stenosis of the pulmonary vein were not found postoperatively. Conclusions This less invasive procedure proved to be safe and presented optimistic outcomes, so it deserves to be promoted as a treatment for lone atrial fibrillation.