Thoracoscopische behandeling van atriumfibrilleren

Patients with symptomatic atrial fibrillation are eligible for treatment aimed at restoring sinus rhythm. This may comprise medication, cardioversion and catheter ablation or surgical ablation. Five years ago we reported on a novel ablation treatment, i.e. video-assisted thoracoscopic surgery. Patients in whom previous catheter ablation has had no result have approximately twice the chance that the atrial fibrillation will stop with this technique, but are also at higher risk of procedural complications in comparison with catheter ablation. In a study of patients with persistent atrial fibrillation, enlarged atria, and, in most cases, a history of unsuccessful catheter ablation, 5 years after this procedure 50% of participants had had no further episodes of atrial fibrillation. Of the other half, 91% had ≤ 3 recurrences a year. Thoracoscopic surgery would appear to be the rational treatment of choice for this group, but direct comparisons with other techniques are not available.

Conflict of interest and financial support: potential conflicts of interest have been reported for this article. ICMJE forms provided by the authors are available online along with the full text of this article.