PDF(Pubmed)
Abstract：
UNASSIGNED: To assess feasibility, safety, and early efficacy of robotic-enhanced epicardial ablation (RE-EA) as first stage of a hybrid approach to patients with persistent (PsAF) and long-standing atrial fibrillation (LSAF).
UNASSIGNED: Single-center, retrospective analysis of patients with documented PsAF and LSAF who underwent RE-EA followed by catheter-guided endocardial ablation. Postoperatively, patients were monitored for major adverse events and underwent rhythm follow-up at 3 and 12 months.
UNASSIGNED: Between January 2021 and June 2023, we performed RE-EA in 64 patients (73.5% male, CHA2DS2-VASc 2.7 ± 1.6, BMI 34.1 ± 6.3 kg/m2). Mean AF preoperative duration and left atrial volume index were, respectively, 85 months and 47.5 mL/m2. Through the robotic approach, the intended lesion set was completed in all patients without cardiopulmonary bypass support, conversion to thoracotomy/sternotomy, blood transfusions, or perioperative mortality. The average LOS was 1.7 days, with only 1 patient requiring intensive care unit admission and >65% of patients discharged within 24 hours. At follow-up, 2 (3.1%) patients experienced new left pleural effusion or hemidiaphragm paralysis requiring treatment. There were no readmissions related to AF, stroke, thromboembolic events, or deaths. The mean interval between the epicardial and endocardial stages of the procedure was 5.9 months. Rhythm follow-up showed AF resolution in 73.4% and 71.9% of patients at 3 and 12 months, respectively.
UNASSIGNED: RE-EA is a feasible and safe, first-stage approach for the treatment of patients with PsAF and LSAF. It improves exposure of the intended targets, favors short hospital stay, and facilitates return to activity with satisfactory AF treatment in the short term.
UNASSIGNED: Single-center, retrospective analysis of patients with documented PsAF and LSAF who underwent RE-EA followed by catheter-guided endocardial ablation. Postoperatively, patients were monitored for major adverse events and underwent rhythm follow-up at 3 and 12 months.
UNASSIGNED: Between January 2021 and June 2023, we performed RE-EA in 64 patients (73.5% male, CHA2DS2-VASc 2.7 ± 1.6, BMI 34.1 ± 6.3 kg/m2). Mean AF preoperative duration and left atrial volume index were, respectively, 85 months and 47.5 mL/m2. Through the robotic approach, the intended lesion set was completed in all patients without cardiopulmonary bypass support, conversion to thoracotomy/sternotomy, blood transfusions, or perioperative mortality. The average LOS was 1.7 days, with only 1 patient requiring intensive care unit admission and >65% of patients discharged within 24 hours. At follow-up, 2 (3.1%) patients experienced new left pleural effusion or hemidiaphragm paralysis requiring treatment. There were no readmissions related to AF, stroke, thromboembolic events, or deaths. The mean interval between the epicardial and endocardial stages of the procedure was 5.9 months. Rhythm follow-up showed AF resolution in 73.4% and 71.9% of patients at 3 and 12 months, respectively.
UNASSIGNED: RE-EA is a feasible and safe, first-stage approach for the treatment of patients with PsAF and LSAF. It improves exposure of the intended targets, favors short hospital stay, and facilitates return to activity with satisfactory AF treatment in the short term.
摘要：
■为了评估可行性，安全,机器人增强心外膜消融（RE-EA）作为持续性房颤（PsAF）和长期房颤（LSAF）患者混合方法的第一阶段的早期疗效。
■单中心，对有记录的PsAF和LSAF患者进行RE-EA和导管引导下心内膜消融的回顾性分析.术后,监测患者的主要不良事件,并在3个月和12个月时进行节律随访.
■在2021年1月至2023年6月之间，我们对64例患者进行了RE-EA（73.5％男性，CHA2DS2-VASc2.7±1.6，BMI34.1±6.3kg/m2）。术前平均房颤持续时间和左心房容积指数,分别,85个月和47.5mL/m2。通过机器人的方法，在没有体外循环支持的所有患者中完成了预期的病变集，转换为开胸/胸骨切开术，输血,或围手术期死亡率。平均LOS为1.7天，只有1名患者需要入住重症监护病房，并且>65%的患者在24小时内出院。在后续行动中,2例（3.1％）患者出现需要治疗的新的左胸腔积液或膈肌麻痹。没有与AF相关的再入院，中风,血栓栓塞事件,或死亡。手术的心外膜和心内膜阶段之间的平均间隔为5.9个月。节律随访显示，在3个月和12个月时，房颤消退率分别为73.4%和71.9%。分别。
■RE-EA是可行且安全的，PsAF和LSAF患者的第一阶段治疗方法。它改善了预期目标的暴露，有利于短期住院，并通过令人满意的AF治疗在短期内促进恢复活动。
■单中心，对有记录的PsAF和LSAF患者进行RE-EA和导管引导下心内膜消融的回顾性分析.术后,监测患者的主要不良事件,并在3个月和12个月时进行节律随访.
■在2021年1月至2023年6月之间，我们对64例患者进行了RE-EA（73.5％男性，CHA2DS2-VASc2.7±1.6，BMI34.1±6.3kg/m2）。术前平均房颤持续时间和左心房容积指数,分别,85个月和47.5mL/m2。通过机器人的方法，在没有体外循环支持的所有患者中完成了预期的病变集，转换为开胸/胸骨切开术，输血,或围手术期死亡率。平均LOS为1.7天，只有1名患者需要入住重症监护病房，并且>65%的患者在24小时内出院。在后续行动中,2例（3.1％）患者出现需要治疗的新的左胸腔积液或膈肌麻痹。没有与AF相关的再入院，中风,血栓栓塞事件,或死亡。手术的心外膜和心内膜阶段之间的平均间隔为5.9个月。节律随访显示，在3个月和12个月时，房颤消退率分别为73.4%和71.9%。分别。
■RE-EA是可行且安全的，PsAF和LSAF患者的第一阶段治疗方法。它改善了预期目标的暴露，有利于短期住院，并通过令人满意的AF治疗在短期内促进恢复活动。
