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Ann Thorac Surg 2007;83:300-302
© 2007 The Society of Thoracic Surgeons

Case Reports

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

Adrian H. Shandling, MDa,b,*, Daniel Rieders, MDa,b, Daniel M. Bethencourt, MDa,b

a Department of Cardiology, Long Beach Memorial Hospital, University of California, Irvine, California
b Department of Thoracic Surgery, Long Beach Memorial Hospital, University of California, Irvine, California

Accepted for publication March 22, 2006.

* Address correspondence to Dr Shandling, 3801 Katella Ave, Suite 401, Los Alamitos, CA 90720 (Email: ashandling{at}aol.com).

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.






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