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Thoracoscopic infrared ablation to create a box lesion as a treatment for atrial fibrillation
BACKGROUND: Creating a box lesion in the posterior wall of the left atrium from the epicardial side of the beating heart remains a challenge. Although a transmural lesion can be created by applying radiofrequency (RF) energy at clampable sites, it is still difficult to create a transmural lesion at...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8742376/ https://www.ncbi.nlm.nih.gov/pubmed/34996500 http://dx.doi.org/10.1186/s13019-021-01750-1 |
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author | Kubota, Hiroshi Ohtsuka, Toshiya Ninomiya, Mikio Nonaka, Takahiro Hisagi, Motoyuki Endo, Hidehito Minegishi, Sachito Tsuchiya, Hiroshi Inaba, Yusuke |
author_facet | Kubota, Hiroshi Ohtsuka, Toshiya Ninomiya, Mikio Nonaka, Takahiro Hisagi, Motoyuki Endo, Hidehito Minegishi, Sachito Tsuchiya, Hiroshi Inaba, Yusuke |
author_sort | Kubota, Hiroshi |
collection | PubMed |
description | BACKGROUND: Creating a box lesion in the posterior wall of the left atrium from the epicardial side of the beating heart remains a challenge. Although a transmural lesion can be created by applying radiofrequency (RF) energy at clampable sites, it is still difficult to create a transmural lesion at unclampable sites because the inner blood flow in the unclampable free wall weakens the thermal effect on the outside. Our aim was to apply the newly developed infrared coagulator to create linear transmural lesions on the beating heart thoracoscopically to treat atrial fibrillation (AF). CASE PRESENTATION: A 71-year-old male was referred to our hospital with a diagnosis of hypertrophic cardiomyopathy and permanent atrial fibrillation. The patient was first diagnosed with atrial fibrillation 20 years before. Direct current cardioversion had been performed every few years a total of four times, but sinus rhythm restoration had always been temporary. On February 27, 2020, thoracoscopic PV isolation together with infrared roof- and bottom-line ablation to create a box lesion and left atrial appendage amputation (LAAA) were performed. The coagulator could be applied to clinical thoracoscopic surgery to successfully create a box lesion without any complication. The patient restored a regular sinus rhythm, it has been maintained for eleven months, and there have been no adverse events. CONCLUSIONS: The infrared coagulator might have enough potential to create transmural lesions on the beating heart in thoracoscopic AF surgery. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13019-021-01750-1. |
format | Online Article Text |
id | pubmed-8742376 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-87423762022-01-10 Thoracoscopic infrared ablation to create a box lesion as a treatment for atrial fibrillation Kubota, Hiroshi Ohtsuka, Toshiya Ninomiya, Mikio Nonaka, Takahiro Hisagi, Motoyuki Endo, Hidehito Minegishi, Sachito Tsuchiya, Hiroshi Inaba, Yusuke J Cardiothorac Surg Case Report BACKGROUND: Creating a box lesion in the posterior wall of the left atrium from the epicardial side of the beating heart remains a challenge. Although a transmural lesion can be created by applying radiofrequency (RF) energy at clampable sites, it is still difficult to create a transmural lesion at unclampable sites because the inner blood flow in the unclampable free wall weakens the thermal effect on the outside. Our aim was to apply the newly developed infrared coagulator to create linear transmural lesions on the beating heart thoracoscopically to treat atrial fibrillation (AF). CASE PRESENTATION: A 71-year-old male was referred to our hospital with a diagnosis of hypertrophic cardiomyopathy and permanent atrial fibrillation. The patient was first diagnosed with atrial fibrillation 20 years before. Direct current cardioversion had been performed every few years a total of four times, but sinus rhythm restoration had always been temporary. On February 27, 2020, thoracoscopic PV isolation together with infrared roof- and bottom-line ablation to create a box lesion and left atrial appendage amputation (LAAA) were performed. The coagulator could be applied to clinical thoracoscopic surgery to successfully create a box lesion without any complication. The patient restored a regular sinus rhythm, it has been maintained for eleven months, and there have been no adverse events. CONCLUSIONS: The infrared coagulator might have enough potential to create transmural lesions on the beating heart in thoracoscopic AF surgery. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13019-021-01750-1. BioMed Central 2022-01-08 /pmc/articles/PMC8742376/ /pubmed/34996500 http://dx.doi.org/10.1186/s13019-021-01750-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Kubota, Hiroshi Ohtsuka, Toshiya Ninomiya, Mikio Nonaka, Takahiro Hisagi, Motoyuki Endo, Hidehito Minegishi, Sachito Tsuchiya, Hiroshi Inaba, Yusuke Thoracoscopic infrared ablation to create a box lesion as a treatment for atrial fibrillation |
title | Thoracoscopic infrared ablation to create a box lesion as a treatment for atrial fibrillation |
title_full | Thoracoscopic infrared ablation to create a box lesion as a treatment for atrial fibrillation |
title_fullStr | Thoracoscopic infrared ablation to create a box lesion as a treatment for atrial fibrillation |
title_full_unstemmed | Thoracoscopic infrared ablation to create a box lesion as a treatment for atrial fibrillation |
title_short | Thoracoscopic infrared ablation to create a box lesion as a treatment for atrial fibrillation |
title_sort | thoracoscopic infrared ablation to create a box lesion as a treatment for atrial fibrillation |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8742376/ https://www.ncbi.nlm.nih.gov/pubmed/34996500 http://dx.doi.org/10.1186/s13019-021-01750-1 |
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