Surgical perspectives in the management of atrial fibrillation

Table 8 Summary of results from studies included looking at high intensity focused ultrasound

Procedure	Ref.	Sample size	Mean follow-up period	Outcome	Important findings
HIFU	Neven et al[45]	Two-year follow-up of 28 people with paroxysmal AF 9 (n = 19) and persistent AF (n = 9) undergoing	Median follow-up 738 d	Following a median follow-up of 738 d, 79% of patients were free of AF. Following a repeat procedure with radiofrequency ablation, 18% of patients maintained freedom of AF	Success rates of HIFU are comparable to radiofrequency ablation but complication rates remain higher for HIFU
HIFU	Klinkenberg et al[47]	15 patients with AF refractory to antiarrhythmic medication underwent HIFU for PVI	24 mo	At 6 mo 40% of patients with 1 epicardial PVI gained sinus rhythm. After 1.3 ± 0.6 yr, 27% of patients had sinus rhythm after 1 epicardial pulmonary vein isolation	Success rate was low in epicardial pulmonary vein isolation done through right-sided VATS using HIFU and was associated with substantial complications
HIFU	Schmidt et al[48]	22 patients with paroxysmal AF who underwent PVI using HIFU	median follow-up of 342 d	71% of patients remained free of any AF/AT recurrence without antiarrhythmic drugs after a procedure	The 12F-HIFU induces a very rapid pulmonary venous isolation in patients

HIFU: High intensity focused ultrasound; PVI: Pulmonary vein isolation; LAA: Left atrial appendage.