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Impact of Thoracoscopic Pulmonary Vein Isolation on Right Ventricular Function: A Pilot Study


De Maat, Gijs E; Hummel, Yoran M; Pozzoli, Alberto; Alfieri, Ottavio R; Rienstra, Michiel; Blaauw, Yuri; Van Gelder, Isabelle C; Mariani, Massimo A (2018). Impact of Thoracoscopic Pulmonary Vein Isolation on Right Ventricular Function: A Pilot Study. BioMed Research International, 2018:7392435.

Abstract

Objective
Thoracoscopic surgical pulmonary vein isolation (sPVI) has been added to the treatment of atrial fibrillation (AF), showing excellent efficacy outcomes. However, data on right ventricular (RV) function following sPVI has never been studied. Our aim was to investigate RV function following sPVI and compare it to patients who underwent endocardial cryoballoon PVI.
Methods
25 patients underwent sPVI and were pair-matched according to age, sex, and AF type with 21 patients who underwent cryoballoon PVI. RV function was measured using tricuspid annular plane systolic excursion (TAPSE) and RV strain with 2D speckle tracking. Echocardiography was performed at baseline and at median 6-month follow-up.
Results
Age was 54 ± 9 years and 84% were male; AF was paroxysmal in 92%. In the sPVI group, TAPSE was reduced with 31% at follow-up echocardiography ( < 0.001) and RV strain showed a 25% reduction compared to baseline ( = 0.018). In the control group, TAPSE and RV strain did not change significantly (-3% and +13%, = 0.410 and = 0.148). Change in TAPSE and RV strain was significantly different between groups ( ≤ 0.001 and = 0.005).
Conclusions
This study shows that RV function is significantly decreased following sPVI. This effect was not observed in the cryoballoon PVI control group.

Abstract

Objective
Thoracoscopic surgical pulmonary vein isolation (sPVI) has been added to the treatment of atrial fibrillation (AF), showing excellent efficacy outcomes. However, data on right ventricular (RV) function following sPVI has never been studied. Our aim was to investigate RV function following sPVI and compare it to patients who underwent endocardial cryoballoon PVI.
Methods
25 patients underwent sPVI and were pair-matched according to age, sex, and AF type with 21 patients who underwent cryoballoon PVI. RV function was measured using tricuspid annular plane systolic excursion (TAPSE) and RV strain with 2D speckle tracking. Echocardiography was performed at baseline and at median 6-month follow-up.
Results
Age was 54 ± 9 years and 84% were male; AF was paroxysmal in 92%. In the sPVI group, TAPSE was reduced with 31% at follow-up echocardiography ( < 0.001) and RV strain showed a 25% reduction compared to baseline ( = 0.018). In the control group, TAPSE and RV strain did not change significantly (-3% and +13%, = 0.410 and = 0.148). Change in TAPSE and RV strain was significantly different between groups ( ≤ 0.001 and = 0.005).
Conclusions
This study shows that RV function is significantly decreased following sPVI. This effect was not observed in the cryoballoon PVI control group.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiovascular Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2018
Deposited On:22 Feb 2019 09:01
Last Modified:25 Sep 2019 00:16
Publisher:Hindawi Publishing Corporation
ISSN:2314-6133
OA Status:Gold
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1155/2018/7392435
PubMed ID:29675429

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