Vol. 22 No. 2 (2018)
REVIEWS

Thoracoscopic ablation for treatment of patients with lone atrial fibrillation in Russia

PDF (Русский)
  • Oleg Pidanov,
  • Alexander Bogachev-Prokophiev,
  • Dmitry Elesin,
  • Eduard Ivanitskiy,
  • Oleg Bobrovskiy,
  • Pavel Shilenko,
  • Pavel Durygin,
  • Alexander Zotov,
  • Sergey Vachev,
  • Victor Vaykin,
  • Sergey Mamchur,
  • Oleg Sapelnikov,
  • Dmitriy Bystrov
Oleg Pidanov
Clinical Hospital of the Presidential Administration, Moscow, Russian Federation
Bio
Alexander Bogachev-Prokophiev
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation
Dmitry Elesin
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation
Eduard Ivanitskiy
Federal Centre for Cardiovascular Surgery, Ministry of Health of Russian Federation, Krasnoyarsk, Russian Federation
Oleg Bobrovskiy
Federal Centre for Cardiovascular Surgery, Ministry of Health of Russian Federation, Krasnoyarsk, Russian Federation
Pavel Shilenko
Federal Center High Medical Technologies, Ministry of Health of Russian Federation, Kaliningrad, Russian Federation
Pavel Durygin
Regional Clinical Hospital, Khanty-Mansiysk, Russian Federation
Alexander Zotov
Federal Research Clinical Center for Specialized Types of Health Care and Medical Technologies of Federal Medical and Biology Agency, Moscow, Russian Federation
Sergey Vachev
Federal Research Clinical Center for Specialized Types of Health Care and Medical Technologies of Federal Medical and Biology Agency, Moscow, Russian Federation
Victor Vaykin
Specialized Cardiac Clinical Hospital, Nizhny-Novgorod, Russian Federation
Sergey Mamchur
Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russian Federation
Oleg Sapelnikov
National Medical Research Center of Cardiology, Ministry of Health of Russian Federation, Moscow, Russian Federation
Dmitriy Bystrov
E. Volosevich City Hospital, Arkhangelsk, Russian Federation
DOI: https://doi.org/10.21688/1681-3472-2018-2-14-21

Published 2018-08-07

Keywords

  • atrial fibrillation,
  • Maze surgery,
  • surgical ablation,
  • totally thoracoscopic ablation

How to Cite

Pidanov, O., Bogachev-Prokophiev, A., Elesin, D., Ivanitskiy, E., Bobrovskiy, O., Shilenko, P., Durygin, P., Zotov, A., Vachev, S., Vaykin, V., Mamchur, S., Sapelnikov, O., & Bystrov, D. (2018). Thoracoscopic ablation for treatment of patients with lone atrial fibrillation in Russia. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 22(2), 14–21. https://doi.org/10.21688/1681-3472-2018-2-14-21

Copyright (c) 2018 Pidanov O.Yu., Bogachev-Prokophiev A.V., Elesin D.A., Ivanitskiy E.A., Bobrovskiy O.A., Shilenko P.A., Durygin P.A., Zotov A.S., Vachev S.A., Vaykin V.E., Mamchur S.E., Sapelnikov O.V., Bystrov D.O.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Aim. Endoscopic surgery demonstrates promising results of treatment in patients with non-paroxysmal atrial fibrillation. Minimally invasive thoracoscopic ablation contributes to the growing interest in such operations all over the world. Nowadays totally thoracoscopic ablations are available for patients in Russian Federation. Emphasis in our study was placed on the collection and analysis of data on thoracoscopic ablation procedures used for treating patients with lone atrial fibrillation.

Methods. The study covered the operations performed by Russian cardiac surgeons over a period up until January 1, 2018. Data collection was based on emailed registration forms containing information about the date of procedures, type of ablation pattern, previous catheter procedures, used devices, methods of left atrial appendage closure and safety profile information. 30-day mortality, conversion to sternotomy/thoracotomy, stroke/ transient ischemic attack, reexplorations, cardiac tamponade and phrenic nerve damage were considered as major complications.

Results. The study encompassed 10 cardiosurgical centers in Russian Federation where totally thoracoscopic ablations had been carried out between 2011– 2018. Six hundred fifty-two procedures were registered. Most patients were ablated in Dallas and Box Lesion patterns. Left atrial appendage exclusion was performed in 90,4% patients. Major complications were observed in 27 (4%) patients, mostly during the “learning curve” period.

Conclusion. The given study is the first attempt to collect and systematize the data on a new surgical procedure for treatment of patients with atrial fibrillation. The data obtained allow for making a conclusion that thoracoscopic ablation is becoming a wide-spread surgical technique to treat patients with lone atrial fibrillation in Russia. The quantity of procedure increases annually. Introducing thoracoscopic procedures in clinical practice may be accompanied by complications at any center. Nevertheless, according to our investigation the rate of complications is low, which enables us to recommend thoracoscopic ablation to treat a numerous cohort of atrial fibrillation patients in Russia.

Received 13 June 2018. Revised 22 July 2018. Accepted 23 July 2018.

Funding: The study did not have sponsorship.

Conflict of interest: Authors declare no conflict of interest.

PDF (Русский)

References

  1. Friberg L., Bergfeldt L. Atrial fibrillation prevalence revisited. J Intern Med. 2013;274(5):461-8. PMID: 23879838. http://dx.doi.org/10.1111/joim.12114
  2. Wilke T., Groth A., Mueller S., Pfannkuche M., Verheyen F., Linder R., Maywald U., Bauersachs R., Breithardt G. Incidence and prevalence of atrial fibrillation: an analysis based on 8.3 million patients. Europace. 2013;15(4):486-93. PMID: 23220354. http://dx.doi.org/10.1093/europace/eus333
  3. Piccini J.P., Hammil B.G., Sinner M.F., Jensen P.N., Hernandez A.F., Heckbert S.R., Benjamin E.J., Curtis L.H. Incidence and prevalence of atrial fibrillation and associated mortality among Medicare beneficiaries, 1993–2007. Circ Cardiovasc Qual Outcomes. 2012;5(1):85-93. PMID: 22235070, PMCID: PMC3332107. http://dx.doi.org/10.1161/CIRCOUTCOMES.111.962688
  4. Шапкина М.Ю., Рябиков А.Н., Воронина Е.В., Маздорова Е.В., Щербакова Л.В., Бобак М., Малютина С.К. Фибрилляция предсердий: распространенность и кросс-секционные детерминанты в популяции Новосибирска (когорта HAPIEE). Атеросклероз. 2016;(3):22-27. Режим доступа: http://www.sibran.ru/journals/issue.php?ID=169011&ARTICLE_ID=169014 [Shapkina M., Ryabikov A., Voronina E., Mazdorova E., Sherbakova L., Bobak M., Malyutina S. Atrial fibrillation: prevalence and cross-sectional determinants in Novosibirsk population (HAPIEE cohort, 9255 participants). Ateroskleroz. 2016;(3):22- 27. (In Russ.) Available from: http://sibran.ru/en/journals/issue.php?ID=169011&ARTICLE_ID=169014]
  5. Thom T., Haase N., Rosamond W., Howard V.J., Rumsfeld J., Manolio T., Zheng Z.J., Flegal K., O'Donnell C., Kittner S., LloydJones D., Goff D.C. Jr., Hong Y., Adams R., Friday G., Furie K., Gorelick P., Kissela B., Marler J., Meigs J., Roger V., Sidney S., Sorlie P., Steinberger J., Wasserthiel-Smoller S, Wilson M, Wolf P; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2006;113(6):e85-151. PMID: 16407573. http://dx.doi.org/10.1161/CIRCULATIONAHA.105.171600
  6. Wolf P.A., Abbott R.D., Kannel W.B. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991;22(8):983-8. PMID: 1866765.
  7. Ganesan A.N., Nandal S., Luker J., Pathak R.K., Mahajan R., Twomey D., Lau D.H., Sanders P. Catheter ablation of atrial fibrillation in patients with concomitant left ventricular impairment: a systematic review of efficacy and effect on ejection fraction. Heart Lung Circ. 2015;24(3):270-80. PMID: 25456506. http://dx.doi.org/10.1016/j.hlc.2014.09.012
  8. McLellan A.J., Ling L.H., Azzopardi S., Lee G.A., Lee G., Kumar S., Wong M.C., Walters T.E., Lee J.M., Looi K.L., Halloran K., Stiles M.K., Lever N.A., Fynn S.P., Heck P.M., Sanders P., Morton J.B., Kalman J.M., Kistler P.M. A minimal or maximal ablation strategy to achieve pulmonary vein isolation for paroxysmal atrial fibrillation: a prospective multi-centre randomized controlled trial (the Minimax study). Eur Heart J. 2015;36(28):1812-21. PMID: 25920401. http://dx.doi.org/10.1093/eurheartj/ehv139
  9. Calkins H., Reynolds M.R., Spector P., Sondhi M., Xu Y., Martin A., Williams C.J., Sledge I. Treatment of atrial fibrillation with antiarrhythmic drugs or radiofrequency ablation: two systematic literature reviews and meta-analyses. Circ Arrhythm Electrophysiol. 2009;2(4):349-61. PMID: 19808490. http://dx.doi.org/10.1161/CIRCEP.108.824789
  10. Ganesan A.N., Shipp N.J., Brooks A.G., Kuklik P., Lau D.H., Lim H.S., Sullivan T., Roberts-Thomson K.C., Sanders P. Long-term outcomes of catheter ablation of atrial fibrillation: a systematic review and meta-analysis. J Am Heart Assoc. 2013;2(2):e004549. PMID: 23537812, PMCID: PMC3647286. http://dx.doi.org/10.1161/JAHA.112.004549
  11. Stulak J.M., Suri R.M., Burkhart H.M., Daly R.C., Dearani J.A., Greason K.L., Joyce L.D., Park S.J., Schaff H.V. Surgical ablation for atrial fibrillation for two decades: are the results of new techniques equivalent to the Cox maze III procedure? J Thorac Cardiovasc Surg. 2014;147(5):1478-86.
  12. Ad N., Henry L., Massimiano P., Pritchard G., Holmes S.D. The state of surgical ablation for atrial fibrillation in patients with mitral valve disease. Curr Opin Cardiol. 2013;28(2):170-80. PMID: 23295553. http://dx.doi.org/10.1097/HCO.0b013e32835ced9c
  13. Ревишвили А.Ш., Сергуладзе С.Ю., Ежова И.В., Кваша Б.И., Сопов О.В., Шмуль А.В. Результаты хирургического лечения изолированных форм фибрилляции предсердий с использованием модифицированной операции «лабиринт». Анналы аритмологии. 2012;9(3):31-39. Режим доступа: http://arrhythmology.pro/files/pdf/aa_2012_03-031-039_0.pdf [Revishvili A.Sh., Serguladze S.Yu., Ezhova I.V., Kvasha B.I., Sopov O.V., Shmul A.V. Results of surgical treatment of isolated atrial fibrillations with the use of modified Maze procedure. Annaly aritmologii. 2012;9(3):31- 39. (In Russ.) Available from: http://arrhythmology.pro/2012-3-031-039]
  14. Бокерия Л.А., Шенгелия Л.Д. Лечение фибрилляции предсердий. Часть I. Долгий путь к «золотому стандарту». Анналы аритмологии. 2014;11(2):64-76. http://dx.doi.org/10.15275/annaritmol.2014.2.1 [Bockeria L.A., Shengelia L.D. Treatment of atrial fibrillation. Part I. Long way to the gold standart. Annaly Патология кровообращения и кардиохирургия. 2018; 22(2):14-21 DOI: 10.21688-1681-3472-2018-2-14-21 REVIEWS 21 aritmologii. 2014;11(2):64-76. (In Russ.) http://dx.doi.org/10.15275/annaritmol.2014.2.1]
  15. Бокерия Л.А., Шенгелия Л.Д. Лечение фибрилляции предсердий. Часть II. Сегодняшние реалии и завтрашние перспективы. Анналы аритмологии. 2014;11(2):76-86. http://dx.doi.org/10.15275/annaritmol.2014.2.2 [Bockeria L.A., Shengelia L.D. Treatment of atrial fibrillation. Part II. Current realities and future prospects. Annaly aritmologii. 2014;11(2):76-86. (In Russ.) http://dx.doi.org/10.15275/annaritmol.2014.2.2]
  16. van Laar C., Kelder J., van Putte B.P. The totally thoracoscopic maze procedure for the treatment of atrial fibrillation. Interact Cardiovasc Thorac Surg. 2017;24(1):102-111. PMID: 27664426. http://dx.doi.org/10.1093/icvts/ivw311
  17. Sirak J.H., Schwartzman D. Interim results of the 5-box thoracoscopic maze procedure. Ann Thorac Surg. 2012;94(6):1880-4. PMID: 22858273. http://dx.doi.org/10.1016/j.athoracsur.2012.06.010
  18. Weimar T., Vosseler M., Czesla M., Boscheinen M., Hemmer W.B., Doll K.N. Approaching a paradigm shift: Endoscopic ablation of lone atrial fibrillation on the beating heart. Ann Thorac Surg. 2012;94(6):1886-92. PMID: 22959565. http://dx.doi.org/10.1016/j.athoracsur.2012.07.035