Thoracoscopic epicardial radiofrequency ablation for atrial fibrillation: commentary

摘要

Development of thoracoscopic epicardial radiofrequency ablation for AF is an innovation that may represent an important advance in treatment for many patients with AF. The epicardial approach enables visualisation of the pulmonary veins and left atrial appendage, facilitating management of these structures. Certain complications of catheter ablation-atrio-oesophageal fistula, phrenic nerve injury, stroke and pulmonary vein stenosis-should, in theory, be avoided by an epicardial approach. However, the thoracoscopic approach may introduce the possibility of other complications-pneumothorax, bleeding from the left atrial appendage, pericarditis, and others. Careful and controlled application of this new procedure will provide the best route to a safe and effective treatment.