Long-term outcomes of thoracoscopic ablation for atrial fibrillation

Abstract

The aim of this work is to analyze the effectiveness of thoracoscopic ablation (TSA) of atrial fibrillation (AF) and to define the risk factors for the return of atrial tachyarrhythmias after TSA in the long-term follow-up period.Methods. From January 2019 to December 2021, 150 patients with symptomatic atrial fibrillation (persistent 29.3% monitoring at the control points of the study, the results of which evaluated the effectiveness of the procedure.Results. The overall efficiency of TSA in the long-term follow-up period was 72.5%. After off-antiarrhythmic drugs, freedom from any atrial tachyarrhythmias was 79.2%, 70.5% and 68.9% after 6, 12 and 24 months, respectively. Additional catheter ablations after 3 months increase the effectiveness of the procedure to 82.9%. Important risk factors for the return of arrhythmia after TSA should be considered the patient’s age, duration of AF, previous catheter ablations and the left atria diameter of more 40 mm.Conclusion. The hybrid approach significantly improves the effectiveness of TSA for patients with non-paroxysmal forms of AF. The results obtained require further study of this problem in order to improve the quality of TSA and determine the optimal set of ablation lines, considering the risk factors for the return of arrhythmia.