Current state of surgical and hybrid therapy of atrial fibrillation

Miloš Táborský, Marek Vícha

Cor Vasa 2017, 59(4):e295-e297 | DOI: 10.1016/j.crvasa.2017.07.001  

Surgical treatment of atrial fibrillation

Aleš Mokráček

Cor Vasa 2017, 59(4):e298-e299 | DOI: 10.1016/j.crvasa.2017.05.014  

Perspectives in surgical ablation of atrial fibrillation

Timo Weimar

Cor Vasa 2017, 59(4):e300-e301 | DOI: 10.1016/j.crvasa.2017.06.013  

Reality of surgical treatment of atrial fibrillation in the Czech Republic - Data from the National Register of Cardiac Surgery (2010-2015)

Petr Budera, Vojtěch Kurfirst, Štěpán Černý, Petr Němec, Jan Pirk, Jaroslav Lindner, Vilém Rohn, Aleš Mokráček, Tomáš Hájek, Marek Pojar, Radim Brát, Petr Šantavý, Piotr Branny, Klára Benešová, Jiří Jarkovský, Zbyněk Straka

Cor Vasa 2017, 59(4):e305-e311 | DOI: 10.1016/j.crvasa.2017.05.010  

Introduction: Surgical ablation is an established treatment of atrial fibrillation (AF) in certain patients indicated for cardiac surgery. However, several strategies and approaches exist at different centers and no recent reports exist about current trends in AF treatment in the Czech Republic. We examined the national trends of concomitant and stand-alone surgical ablation of AF.Methods: Data from the National Register of Cardiac Surgery and from a special questionnaire created especially for this analysis, were used for evaluation of trends in the rate of concomitant surgical ablations in AF patients, rates of different concomitant procedures,...

Thoracoscopic ablation of atrial fibrillation - Should we still be concerned about periprocedural complications?

Petr Budera, Pavel Osmančík, David Talavera, Anna Kraupnerová, Vitalii Rizov, Richard Fojt, Zbyněk Straka

Cor Vasa 2017, 59(4):e317-e324 | DOI: 10.1016/j.crvasa.2017.06.004  

Introduction: Minimally invasive surgical ablations are becoming an interesting treatment option for patients with stand-alone atrial fibrillation (AF). However, they are in general connected with higher rates of perioperative complications. The aim of this study was to summarize the complications of all such procedures performed in our center and compare them with similar recent papers.Material and methods: All perioperative and 30-day complications of thoracoscopic ablations of AF performed in our center were collected and analyzed. Recent literature was searched for studies describing the outcomes of thoracoscopic and hybrid ablations. Rates...

Thoracoscopic radiofrequency ablation for lone atrial fibrillation: Box-lesion technique

Aleš Klváček, Andrea Steriovský, Jakub Konečný, Tomáš Skála, Vladimír Lonský, Petr Šantavý

Cor Vasa 2017, 59(4):e332-e336 | DOI: 10.1016/j.crvasa.2017.05.009  

Background: We report the feasibility and outcomes of box-lesion ablation technique to treat stand-alone atrial fibrillation (AF).Methods: There were 31 patients with a mean age of 63.3 ± 8.4 years who underwent bilateral totally thoracoscopic ablation of symptomatic paroxysmal AF (n = 8; 25.8%) and long-standing persistent AF (n = 23; 75.2%). The box-lesion procedure included bilateral pulmonary vein and left atrial posterior wall ablation using irrigated bipolar radiofrequency with documentation of conduction block.Results: There were no intra- or perioperative ablation-related complications. There was no operative mortality, no myocardial...

Hybrid dual stage closed chest ablation of persistent atrial fibrillation

Adam Wojtaszczyk, Piotr Buchta, Krzysztof Myrda, Mariusz Gąsior, Oskar Kowalski, Zbigniew Kalarus, Krzysztof Filipiak, Marian Zembala, Michał O. Zembala

Cor Vasa 2017, 59(4):e337-e344 | DOI: 10.1016/j.crvasa.2017.06.008  

The hybrid ablation (HABL) of atrial fibrillation which combines endoscopic, minimally invasive, closed chest epicardial ablation with endocardial CARTO-guided accuracy was introduced to overcome limitations of current therapeutic options for patients with persistent (PSAF) and long-standing persistent atrial fibrillation (LSPAF). The purpose of this single-centre, prospective clinical registry was to evaluate procedural safety and feasibility as well as effectiveness of the HABL in patients with PSAF and LSPAF 1-year post-procedure. From July 2009 to December 2014, ninety (n = 90) patients with PSAF (n = 39) and LSPAF (n = 51) underwent HABL. Mean...

Middle-term results of hybrid atrial fibrillation ablation using AtriCure system

Alan Bulava, Aleš Mokráček, Martin Eisenberger, Vojtěch Kurfirst, Ladislav Dušek

Cor Vasa 2017, 59(4):e345-e352 | DOI: 10.1016/j.crvasa.2017.05.004  

Introduction: Long-term results of catheter ablation (CA) for persistent and long-standing persistent atrial fibrillation (AF) are disappointing. The hybrid approach is currently one of options for overcoming the limitations of CA.Aim: To evaluate the safety and medium-term efficacy of the hybrid approach in patients with persistent and long-standing persistent AF.Methods: All patients underwent epicardial thoracoscopic radiofrequency (RF) pulmonary vein (PV) isolation using the AtriCure clamp followed by left atrial (LA) linear lesions (using a linear pen), Marshall ligament disruption, and LA appendage exclusion using an AtriClip. All patients...

The incidence and types of atrial tachyarrhythmias occurring after hybrid ablation procedures

Pavel Osmančík, Petr Budera, Dalibor Heřman, Jana Ždárská, Radka Procházková, Zbyněk Straka

Cor Vasa 2017, 59(4):e353-e358 | DOI: 10.1016/j.crvasa.2017.06.003  

Background: Despite successful creation of box lesions during hybrid ablations, reoccurrence of atrial fibrillation (AF) and/or regular atrial arrhythmias (ATs) still occur. The goal of this study was to describe the incidence and types of regular ATs that occur after successful hybrid ablations.Methods: Patients after hybrid ablation for persistent or long-standing persistent AF were enrolled. Patients, in whom regular AT occurred, were recommended for electrophysiological study and re-ablation. The mechanism of regular AT was described using activation and entrainment mapping.Results: Regular AT occurred in 5 (10%) patients from 50 patients,...

Electrophysiological findings after surgical ablation of atrial fibrillation using AtriCure system

Alan Bulava, Aleš Mokráček, Martin Eisenberger, Vojtěch Kurfirst, Ladislav Dušek

Cor Vasa 2017, 59(4):e359-e366 | DOI: 10.1016/j.crvasa.2017.04.002  

Introduction: Long-term results of catheter ablation (CA) of persistent and long-standing persistent atrial fibrillation (AF) have been disappointing. The hybrid approach is one method of overcoming the limitations of CA.Aim: To present electrophysiological (EP) findings in patients undergoing hybrid surgical ablation to treat atrial fibrillation.Methods: Patients with persistent and long-standing persistent AF underwent thoracoscopic epicardial radiofrequency (RF) isolation of the pulmonary veins (PV) using AtriCure clamps followed by linear ablations in the left atrium (LA) using a linear pen and complemented by Marshall ligament disruption...

Arrhythmia recurrence in patients following cardiac surgery with concomitant therapy of atrial fibrillation - experience of our cardiac center

Marek Janotka, Jan Škoda, Jan Petrů, Lucie Šedivá, Milan Chovanec, Štěpán Černý, Petr Pavel, Martin Michel, Ivo Skalský, Miroslava Benešová, Petr Neužil

Cor Vasa 2017, 59(4):e367-e375 | DOI: 10.1016/j.crvasa.2017.06.016  

Introduction: Surgical treatment of atrial fibrillation (AF) is a common and time-proven treatment method for this type of arrhythmias both as a separate procedure and as a procedure related to cardiac surgery for another indication (concomitant procedure). Patients experience arrhythmia recurrence despite highly efficient surgical treatment. These arrhythmias are often resistant to pharmacological treatment (due to an extensive fibrous substrate); therefore, electroanatomical mapping accompanying catheter ablation is significantly more effective. The arrhythmogenic fibrous substrate is a result of both a primary cardiac disease (an underlying disease...

Effectivity of left atrial appendage occlusion with AtriClip in 155 consecutive patients - Single center study

Vojtěch Kurfirst, Aleš Mokráček, Júlia Čanádyová, Alan Bulava, Ladislav Pešl

Cor Vasa 2017, 59(4):e376-e380 | DOI: 10.1016/j.crvasa.2017.05.015  

Objectives: Left atrial appendage (LAA) plays a crucial role in the etiopathogenesis of the stroke in patients with non-valvular atrial fibrillation. Different methods of surgical occlusion of the LAA have been associated with different levels of acute and chronic success rate. This paper presents our experience with LAA occlusion using the AtriClip.Methods: 155 patients undergoing cardiac surgery procedures with epicardial AtriClip exclusion of the LAA were enrolled in the study. The AtriClip was placed via a sternotomy, thoracotomy or from a thoracoscopic approach. Postoperative variables such as thromboembolic events, clip stability, and endocardial...

The effect of surgical access for mitral valve surgery on incidence of atrial fibrillation and atrioventricular block

Tomáš Toporcer, Ján Luczy, Adrián Kolesár, Martin Ledecký, František Sabol

Cor Vasa 2017, 59(4):e381-e388 | DOI: 10.1016/j.crvasa.2017.05.017  

Atrial fibrillation and conduction disorders are very common and severe postoperative complications in heart surgery.Retrograde analysis of patients (n = 103) who had undergone mitral valve surgery or concomitant mitral and tricuspid valve surgery was performed (from January 2006 to December 2016). Patients from each group were divided into two groups: a subgroup with surgery access through the right atrium and interatrial septum (transseptal access) and a subgroup with surgery access through the left atrium (left atrial access). The following data were recorded for all patients: age, sex, extracorporeal circulation time, aortic clamping time,...

The current technical options for minimally invasive surgical treatment of atrial fibrillation

Vojtěch Kurfirst, Aleš Mokráček, Petr Budera, Zbyněk Straka, Marek Pojar, Jan Harrer

Cor Vasa 2017, 59(4):e312-e316 | DOI: 10.1016/j.crvasa.2017.06.007  

Minimally invasive surgical treatment of AF as well as technical tools and instruments are still evolving. The most suitable patients for this method are the patients with persistent and long-persistent AF. This article describes mini-invasive surgical methods and tools for treatment of atrial fibrillation available on the Czech market nowadays.

Atrial fibrillation and its relation to cardiac diseases and sudden cardiac death

Jiří Šmíd, Richard Rokyta

Cor Vasa 2017, 59(4):e325-e331 | DOI: 10.1016/j.crvasa.2017.06.005  

Atrial fibrillation (AF) is the most common arrhythmia in adults. Many studies have reported an association between atrial fibrillation and other cardiac diseases including sudden cardiac death (SCD). According to the literature, the prevalence and incidence of atrial fibrillation have been increasing and AF is associated with higher mortality and morbidity. An increased incidence of AF has been described in patients with ischemic heart disease, heart failure, and arterial hypertension. These conditions share some pathophysiological mechanisms with atrial fibrillation, which is, reciprocally, one of their risk factors. As a result, mortality is 2-4-fold...

The authors of lipid guidelines are at odds with their own recommendations

Richard Češka, Michal Vrablík

Cor Vasa 2017, 59(4):e416-e417 | DOI: 10.1016/j.crvasa.2017.03.012  

In the era of evidence-based medicine, diagnostic and treatment guidelines prepared by professional societies, as well as expert opinions, constitute substantial guidance for practicing physicians. However, in a joint ESC/EAS publication, "Task Force consensus statement on proprotein convertase subtilisin/Kexin Type 9 inhibitors: practical guidance for use in patients at very high cardiovascular risk",' has caught a significant number of practicing physicians off guard and left them perplexed. Physicians are obliged to treat patients in accordance with the latest scientific findings, which those attempting to form legal interpretations often confuse...

2016 ESC/EAS Guidelines for the management of dyslipidaemias: Summary of the document prepared by the Czech Society of Cardiology

Petr Janský, Hana Rosolová, Michal Vrablík

Cor Vasa 2017, 59(4):e389-e415 | DOI: 10.1016/j.crvasa.2017.03.007  

Consensus Statement on Surgical Treatment of Atrial Fibrillation (CSCVS - The Czech Society of Cardiovascular Surgery)

Aleš Mokráček, Vojtěch Kurfirst, Zbyněk Straka, Petr Budera

Cor Vasa 2017, 59(4):e302-e304 | DOI: 10.1016/j.crvasa.2017.05.008  

Léčba hypercholesterolemie u pacientů ve vysokém/velmi vysokém kardiovaskulárním riziku

Cor Vasa 2017, 59(4):474-475  

ECHODNY 2017

Cor Vasa 2017, 59(4):476-480  

Editorial Board

Editorial board

Cor Vasa 2017, 59(4):i | DOI: 10.1016/S0010-8650(17)30127-3