Thoracoscopic Microwave Epicardial Ablation: Feasibility for the Treatment of Idiopathic Sinus Node Tachycardia

• Published in: The Annals of thoracic surgery Vol. 83; no. 1; pp. 300 - 302
• Main Authors: Shandling, Adrian H., MD, Rieders, Daniel, MD, Bethencourt, Daniel M., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 2007; Elsevier Science
• Subjects: Adult; Biological and medical sciences; Bronchoscopy; Cardiac dysrhythmias; Cardiology. Vascular system; Cardiothoracic Surgery; Catheter Ablation - methods; Endoscopy; Female; Heart; Humans; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Microwaves - therapeutic use; Pericardium; Phrenic Nerve - physiopathology; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Surgery of the respiratory system; Tachycardia, Sinus - surgery; Thoracoscopy; 24; Sinus node; Arrhythmia; Respiratory disease; Idiopathic; Microwave; Cardiovascular disease; Thorax; Ablation; Excitability disorder; Treatment; Sinus tachycardia; Heart disease; Surgery; Feasibility; Endoscopy; Epicardial; Thoracoscopy
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2006.03.118

Inappropriate sinus tachycardia is a potentially debilitating condition with tachycardia emanating from the sinus node region. Endocardial radiofrequency energy ablation is the current preferred mode of treatment for symptomatic medication failures. Phrenic nerve damage can result from this procedure. We report a case in which the potential for phrenic nerve damage was avoided by using a thoracoscopic approach to displace the phrenic nerve posteriorly and perform epicardial microwave ablation. This resulted in the successful treatment of a patient with highly symptomatic inappropriate sinus tachycardia.