Epicardial off-pump pulmonary vein isolation and vagal denervation improve long-term outcome and quality of life in patients with atrial fibrillation

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Presentation transcript:

Epicardial off-pump pulmonary vein isolation and vagal denervation improve long-term outcome and quality of life in patients with atrial fibrillation Louise Bagge, MD, Per Blomström, MD, PhD, Leif Nilsson, MD, PhD, Gunnar Myrdal Einarsson, MD, PhD, Lena Jidéus, MD, PhD, Carina Blomström-Lundqvist, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 137, Issue 5, Pages 1265-1271 (May 2009) DOI: 10.1016/j.jtcvs.2008.12.017 Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 A, Sites of high-frequency stimulation of ganglionated plexi (GP). In every patient 10 sites on the right side (R1–R10) and 10 on the left side (L1–L10) of the left atrium were mapped. RSPV, Right superior pulmonary vein; RIPV, right inferior pulmonary vein; LSPV, left superior pulmonary vein; LIPV, left inferior pulmonary vein; LA, left atrium; LAA, left atrium appendage; AV, atrioventricular; R, right; L, left. B, Results of epicardial GP mapping. High-frequency stimulation map showing distribution of active GP sites displayed as percentages as well as by grayscale. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1265-1271DOI: (10.1016/j.jtcvs.2008.12.017) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Comparison of quality of life assessed by the Short Form-36 questionnaire for QoL. A, Baseline (n = 42) versus 12 months following surgery (n = 33). Error bars show 95% confidence limits of the mean. ▴, Baseline; ■, 12-month follow-up; PF, physical functioning; RP, role limitation due to physical problems; BP, bodily pain; GH, general health; VT, vitality; SF, social functioning; RE, role limitation due to emotional problems; MH, mental health. PF: P = .0019; RP: P = .0078; BP: P = .39; GH: P = .0070; VT: P = .00014; SF: P = .00014; RE: P = .00059; MH: P = .00036. B, Twelve months after surgery (n = 33) versus the general Swedish population. ■, 12-month follow-up; ○, Swedish general population. PF: P = .038; RP: P = .0023; BP: P = .78; GH: P = .0065; VT: P = .046; SF: P = .096; RE: P = .080; MH: P = 0.53. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1265-1271DOI: (10.1016/j.jtcvs.2008.12.017) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Learning curve with procedure time averaged per group of 10 consecutive patients. ∗The time at which major bleeding occurred. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1265-1271DOI: (10.1016/j.jtcvs.2008.12.017) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions