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Editorial Commentary| Volume 14, ISSUE 9, P1289-1290, September 2017

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Minimally invasive surgical ablation: Should we ablate harder or smarter?

  • David Callans
    Correspondence
    Address reprint requests and correspondence: Dr David Callans, Cardiac Electrophysiology, University of Pennsylvania Health System, 3400 Spruce St, Founders 9 Pavilion, Philadelphia, PA 19104.
    Affiliations
    Cardiac Electrophysiology Section, Cardiovascular Division, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    Search for articles by this author
  • Ramanan Kumareswaran
    Affiliations
    Cardiac Electrophysiology Section, Cardiovascular Division, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    Search for articles by this author
Published:May 08, 2017DOI:https://doi.org/10.1016/j.hrthm.2017.05.008
Minimally invasive surgical ablation: Should we ablate harder or smarter?
Previous ArticleLong-term outcomes of minimally invasive surgical ablation for atrial fibrillation: A single-center experience
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      Many patients still remain symptomatic despite adequate rate control and may benefit from rhythm control approach. The efficacy of antiarrhythmic drugs (AADs) is modest at best and carries a long list of side effects including proarrhythmia.
      • Jais P.
      • Cauchemez B.
      • Macle L.
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      This has led to many patients opting to undergo invasive procedures to improve their quality of life.
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      References

        • Dorian P.
        • Jung W.
        • Newman D.
        • Paquette M.
        • Wood K.
        • Ayers G.M.
        • Camm J.
        • Akhtar M.
        The impairment of health-related quality of life in patients with intermittent atrial fibrillation: implications for the assessment of investigational therapy.
        J Am Coll Cardiol. 2000; 36: 1303-1309
        View in Article
        • Jais P.
        • Cauchemez B.
        • Macle L.
        • et al.
        Catheter ablation versus antiarrhythmic drugs for atrial fibrillation the A4 study.
        Circulation. 2008; 118: 2498-2505
        View in Article
        • Millar R.C.
        • Arcidi J.M.
        • Alison P.J.
        The Maze III procedure for atrial fibrillation: should the indications be expanded?.
        Ann Thorac Surg. 2000; 70: 1580-1586
        View in Article
        • Piccini J.P.
        • Lopes R.D.
        • Kong M.H.
        • Hasselblad V.
        • Jackson K.
        • Al-Khatib S.M.
        Pulmonary vein isolation for the maintenance of sinus rhythm in patients with atrial fibrillation: a meta-analysis of randomized, controlled trials.
        Circ Arrhythm Electrophysiol. 2009; 2: 626-633
        View in Article
        • Saini A.
        • Hu Y.L.
        • Kasirajan V.
        • Han F.T.
        • Khan M.Z.
        • Wolfe L.
        • Gunda S.
        • Koneru J.N.
        • Ellenbogen K.A.
        Long-term outcomes of minimally invasive surgical ablation for atrial fibrillation: A single center experience.
        Heart Rhythm. 2017; 14: 1281-1288
        View in Article
        • Pathak R.K.
        • Middeldorp M.E.
        • Lau D.H.
        • et al.
        Aggressive risk factor reduction study for atrial fibrillation and implications for the outcome of ablation: the ARRESTAF cohort study.
        J Am Coll Cardiol. 2014; 64: 2222-2231
        View in Article
        • Verma A.
        • Jiang C.Y.
        • Betts T.R.
        • et al.
        • STAR AF II Investigators
        Approaches to catheter ablation for persistent atrial fibrillation.
        N Engl J Med. 2015; 372: 1812-1822
        View in Article
        • Dixit S.
        • Marchlinski F.E.
        • Lin D.
        • et al.
        Randomized ablation strategies for the treatment of persistent atrial fibrillation: RASTA study.
        Circ Arrhythm Electrophysiol. 2012; 5: 287-294
        View in Article
        • Miller J.M.
        • Kowal R.C.
        • Swarup V.
        • et al.
        Initial independent outcomes from focal impulse and rotor modulation ablation for atrial fibrillation: multicenter FIRM registry.
        J Cardiovasc Electrophysiol. 2014; 25: 921-929
        View in Article
        • Hansen B.J.
        • Zhao J.
        • Csepe T.A.
        • Moore B.T.
        • et al.
        Atrial fibrillation driven by micro-anatomic intramural re-entry revealed by simultaneous subepicardial and sub-endocardial optical mapping in explanted human hearts.
        Eur Heart J. 2015; 36: 2390-2401
        View in Article
        • Masoudi A.F.
        • Calkins H.
        • Kavinsky C.J.
        • Drozda J.P.
        • Gainsley P.
        • Slotwiner D.J.
        • Turi Z.G.
        2015 ACC/HRS/SCAI left atrial appendage occlusion device societal overview.
        Heart Rhythm. 2015; 12: e122-e136
        View in Article
        • Ad N.
        • Damiano R.J.
        • Badhwar V.
        • Calkins H.
        • Meir M.L.
        • Nitta T.
        • Holmes S.D.
        • Weinstein A.A.
        • Gillinov M.
        Expert consensus guidelines: examining surgical ablation for atrial fibrillation.
        J Thorac Cardiovasc Surg. 2017; 153: 1330-1354
        View in Article

      Article info

      Publication history

      Published online: May 08, 2017

      Identification

      DOI: https://doi.org/10.1016/j.hrthm.2017.05.008

      Copyright

      © 2017 Heart Rhythm Society. All rights reserved.

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