Of 107 patients undergoing modified endoscopic ablation, 58 had paroxysmal AF and 49 had persistent or long-standing AF. The procedure was performed on the beating heart through three ports on the left chest wall. Three circular and two linear lesions were made on the left atrium. The left atrial appendage was excised by stapler. Echocardiography was performed preoperatively and at the 2-year follow-up.
Most patients (86.9%) patients were in sinus rhythm (SR) postoperatively. Fourteen patients (5 with paroxysmal AF and 9 with persistent/long-standing AF) failed to maintain SR. Echocardiographic data indicated that the left atrial diameter decreased only in the patients with postoperative SR but continued to increase in patients with fail SR maintenance. Left atrial function was also improved after the procedure, especially in patients with preoperative nonparoxysmal AF or with postoperative SR maintenance. Furthermore, left atrial function in patients who failed to restore SR was not worsened even with left atrial appendage excision.
Modified endoscopic procedure for AF improved post-procedural left atrial function of patients with SR maintenance. The left atrial function of patients with failed SR maintenance was also not worsened after left atrial appendage excision.