Recurrence of atrial fibrillation ten years after thoracoscopic transdiaphragmatic epicardial radiofrequency ablation

Atrial fibrillation (AF) is the most frequent cardiac arrhythmia [1]. According to the European Society of Cardiology, AF may affect up to 3% of adults aged 20 years or older [1]. It is also associated with high rates of mortality and morbidity [1, 2]. Over the last 30 years, the number of invasive rhythm control methods has significantly increased. Percutaneous approaches, due to their low level of invasiveness, short period of postprocedural recovery, and low rate of complications, have gained popularity. However, it has been shown that sinus rhythm is present in only 66% to 89% of patients after 12 months of follow-up, and that the procedure must be repeated in 10% to 25% of patients to achieve a satisfactory effect [2, 3]. An alternative method of treatment in cases of AF resistant to standard therapy is epicardial radiofrequency (RF) ablation. This method is safe for the patient but requires general anaesthesia and an experienced surgeon to perform the procedure. Our previous short-term observations showed that after one year, the rate of successful thoracoscopic transdiaphragmatic ablation remains at over 80% after a single procedure [2]. Herein we present our 10-year outcomes of thoracoscopic transdiaphragmatic epicardial RF ablation.