First experience of treating patients with atrial fibrillation using thoracoscopic isolation with left atrial appendage excision in the North-Western State Medical University named after I.I. Mechnikov

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Abstract

The given article describes the first experience of a thoracoscopic isolation of pulmonary veins and left atrial appendage excision in the North-Western State Medical University named after I.I. Mechnikov. The clinical case features a woman with a long history of paroxysmal atrial fibrillation, severe left atrium dilation, failure in a pace control drug therapy and no effect of radiofrequency catheter isolation of pulmonary veins.

Additionally, there outlined the advantages and the significance of employing the method of thoracoscopic ablation in patients with symptomatic paroxysmal and long-term persistent atrial fibrillation, — in case if antiarrythmic drugs and radiofrequency catheter ablation proved ineffective, as well as in patients with a long-term persistent atrial fibrillation along with a severe left atrium dilation.

About the authors

Dmitrii A. Yakovlev

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: dmitrii.yakovlev@szgmu.ru
ORCID iD: 0000-0002-1994-8470
SPIN-code: 5422-3296

MD, Cand. Sci. (Med.), cardiovascular surgeon, assistant at the department of surgery

Russian Federation, Saint Petersburg

Andrey I. Lenkin

North-Western State Medical University named after I.I. Mechnikov

Email: Andrei.Lenkin@szgmu.ru
ORCID iD: 0000-0003-3099-9276
SPIN-code: 4155-0635

MD, Dr. Sci. (Med.), Assistant Professor

Russian Federation, Saint Petersburg

Vera V. Stepanova

North-Western State Medical University named after I.I. Mechnikov

Email: veragrokhotova@mail.ru
ORCID iD: 0000-0003-2540-6544
SPIN-code: 9710-3406

MD, Cand. Sci. (Med.), cardiovascular surgeon

Russian Federation, Saint Petersburg

Valeriy A. Marinin

North-Western State Medical University named after I.I. Mechnikov

Email: marininva@mail.ru
ORCID iD: 0000-0002-8141-5149
SPIN-code: 3681-6714

MD, Dr. Sci. (Med.), cardiovascular surgeon

Russian Federation, Saint Petersburg

Nikolai V. Petrov

North-Western State Medical University named after I.I. Mechnikov

Email: npeval@yandex.ru
ORCID iD: 0009-0009-1477-4879

cardiovascular surgeon

Russian Federation, Saint Petersburg

Vladislav K. Verendeev

North-Western State Medical University named after I.I. Mechnikov

Email: verendeev02@mail.ru
ORCID iD: 0000-0003-4720-4476

medical student

Russian Federation, Saint Petersburg

References

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Supplementary files

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2. Fig. 1. 24-hour ECG monitor (50 mm/s) of patient D in the presence of paroxysmal atrial fibrillation

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3. Fig. 2. Stage of the thoracoscopic isolation of the pulmonary veins with a bipolar clamp electrode. Ao — aorta; ЛП — left atrium; ПП — right atrium; ПЛВ — right pulmonary veins; ВПВ — superior vena cava

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4. Fig. 3. Stage of ablation with a unidirectional bipolar electrode of the ganglion plexuses in the right pulmonary veins ostium

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5. Fig. 4. Formation of ablation lines during thoracoscopic RFA: ПЛВ — right pulmonary veins (single collector); ЛВЛВ — left superior pulmonary vein; ЛНЛВ — left inferior pulmonary vein; ЛП — left atrium; ЛА — pulmonary artery Ablation lines are indicated in red

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