Minimally Invasive Epicardial Ablation of Lone Atrial Fibrillation in Pediatric Patient Giuseppe Nasso, MD, Raffaele Bonifazi, MD, Flavio Fiore, MD, Giuseppe.

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Minimally Invasive Epicardial Ablation of Lone Atrial Fibrillation in Pediatric Patient Giuseppe Nasso, MD, Raffaele Bonifazi, MD, Flavio Fiore, MD, Giuseppe Balducci, MD, Massimiliano Conte, MD, Vincenzo Lopriore, MD, Giuseppe Speziale, MD The Annals of Thoracic Surgery Volume 90, Issue 4, Pages e49-e51 (October 2010) DOI: 10.1016/j.athoracsur.2010.06.112 Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Intraoperative videoscopic views. (A) The branches of the epicardial radiofrequency ablation device (white arrowheads) are put into position to embrace the left atrium around the four orifices of the pulmonary veins. (B) At the end of the ablation procedure, the visual inspection confirms the creation of the lesion (white arrows). The Annals of Thoracic Surgery 2010 90, e49-e51DOI: (10.1016/j.athoracsur.2010.06.112) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 “Work-in-progress” flow chart for the indications to the minimally epicardial ablation of lone, symptomatic, drug-resistant atrial fibrillation (AF). This procedure may be indicated either as the first therapeutic choice, or after failed transcatheter ablation, or as a staged approach. *Staged approach = minimally invasive epicardial ablation followed by the creation of additional atrial lesions through the transcatheter route. The Annals of Thoracic Surgery 2010 90, e49-e51DOI: (10.1016/j.athoracsur.2010.06.112) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions