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Electrophysiological Evaluation of Thoracoscopic Pulmonary Vein Isolation

Although the majority of patients with atrial fibrillation and an indication for non-pharmacological therapy is treated with catheter ablation, thoracoscopic surgery is an emerging technique that aims at combining the results of the classic Cox Maze operation with a less invasive approach. Recurrences after thoracoscopic surgery are mainly caused by incomplete ablation lines. Literature on electrophysiological confirmation of thoracoscopic pulmonary vein isolation is limited.

Currently, surgical confirmation of uni- or bidirectional conduction block may be hampered by insufficient resolution of the mapping material available. In hybrid procedures, electrophysiologists and surgeons join forces to combine their know-how and skills which may lead to increased procedural success rates by minimizing the chance of incomplete PV isolation or absence of conduction block across an alternative ablation line. Here we describe techniques for thoracoscopic mapping and present a literature review.


Credits: Joris R. de Groot; Wouter R. Berger; Sébastien P.J. Krul; WimJan van Boven; Sacha P. Salzberg; Antoine H.G. Driessen

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Introduction to AFib
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