Impact of Thoracoscopic Pulmonary Vein Isolation on Right Ventricular Function: A Pilot Study. 2018

Gijs E De Maat, and Yoran M Hummel, and Alberto Pozzoli, and Ottavio R Alfieri, and Michiel Rienstra, and Yuri Blaauw, and Isabelle C Van Gelder, and Massimo A Mariani
Department of Cardiothoracic Surgery and Cardiology, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, Netherlands.

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 (p < 0.001) and RV strain showed a 25% reduction compared to baseline (p = 0.018). In the control group, TAPSE and RV strain did not change significantly (-3% and +13%, p = 0.410 and p = 0.148). Change in TAPSE and RV strain was significantly different between groups (p ≤ 0.001 and p = 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.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010865 Pilot Projects Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work. Pilot Studies,Pilot Study,Pilot Project,Project, Pilot,Projects, Pilot,Studies, Pilot,Study, Pilot
D011667 Pulmonary Veins The veins that return the oxygenated blood from the lungs to the left atrium of the heart. Pulmonary Vein,Vein, Pulmonary,Veins, Pulmonary
D004452 Echocardiography Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. Echocardiography, Contrast,Echocardiography, Cross-Sectional,Echocardiography, M-Mode,Echocardiography, Transthoracic,Echocardiography, Two-Dimensional,Transthoracic Echocardiography,2-D Echocardiography,2D Echocardiography,Contrast Echocardiography,Cross-Sectional Echocardiography,Echocardiography, 2-D,Echocardiography, 2D,M-Mode Echocardiography,Two-Dimensional Echocardiography,2 D Echocardiography,Cross Sectional Echocardiography,Echocardiography, 2 D,Echocardiography, Cross Sectional,Echocardiography, M Mode,Echocardiography, Two Dimensional,M Mode Echocardiography,Two Dimensional Echocardiography
D005260 Female Females
D006352 Heart Ventricles The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation. Cardiac Ventricle,Cardiac Ventricles,Heart Ventricle,Left Ventricle,Right Ventricle,Left Ventricles,Right Ventricles,Ventricle, Cardiac,Ventricle, Heart,Ventricle, Left,Ventricle, Right,Ventricles, Cardiac,Ventricles, Heart,Ventricles, Left,Ventricles, Right
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013906 Thoracoscopy Endoscopic examination, therapy or surgery of the pleural cavity. Endoscopy, Pleural,Pleural Endoscopy,Pleuroscopy,Surgical Procedures, Thoracoscopic,Thoracoscopic Surgical Procedures,Surgery, Thoracoscopic,Thoracoscopic Surgery,Endoscopies, Pleural,Pleural Endoscopies,Pleuroscopies,Surgeries, Thoracoscopic,Surgical Procedure, Thoracoscopic,Thoracoscopic Surgeries,Thoracoscopic Surgical Procedure,Thoracoscopies
D016278 Ventricular Function, Right The hemodynamic and electrophysiological action of the right HEART VENTRICLE. Right Ventricular Function,Function, Right Ventricular,Functions, Right Ventricular,Right Ventricular Functions,Ventricular Functions, Right

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