Epicardial off-pump pulmonary vein isolation and vagal denervation improve long-term outcome and quality of life in patients with atrial fibrillation

A, Sites of high-frequency stimulation of ganglionated plexi (GP). In every patient 10 sites on the right side (R1–R10) and 10 on the left side (L1–L10) of the left atrium were mapped. RSPV, Right superior pulmonary vein; RIPV, right inferior pulmonary vein; LSPV, left superior pulmonary vein; LIPV, left inferior pulmonary vein; LA, left atrium; LAA, left atrium appendage; AV, atrioventricular; R, right; L, left. B, Results of epicardial GP mapping. High-frequency stimulation map showing distribution of active GP sites displayed as percentages as well as by grayscale.

Comparison of quality of life assessed by the Short Form-36 questionnaire for QoL. A, Baseline (n = 42) versus 12 months following surgery (n = 33). Error bars show 95% confidence limits of the mean. ▴, Baseline; ■, 12-month follow-up; PF, physical functioning; RP, role limitation due to physical problems; BP, bodily pain; GH, general health; VT, vitality; SF, social functioning; RE, role limitation due to emotional problems; MH, mental health. PF: P = .0019; RP: P = .0078; BP: P = .39; GH: P = .0070; VT: P = .00014; SF: P = .00014; RE: P = .00059; MH: P = .00036. B, Twelve months after surgery (n = 33) versus the general Swedish population. ■, 12-month follow-up; ○, Swedish general population. PF: P = .038; RP: P = .0023; BP: P = .78; GH: P = .0065; VT: P = .046; SF: P = .096; RE: P = .080; MH: P = 0.53.

Learning curve with procedure time averaged per group of 10 consecutive patients. ^∗The time at which major bleeding occurred.