Thoracoscopic radiofrequency pulmonary vein isolation and atrial appendage occlusion.

A 46-year-old woman with a 7-year history of profoundly symptomatic daily paroxysmal atrial fibrillation had undergone two percutaneous catheter ablations and multiple medication trials. With informed consent, bilateral pulmonary vein isolation and left atrial appendage occlusion as well as ablation of ganglionated plexi were performed by a totally thoracoscopic technique employing a bipolar radiofrequency device. She was discharged home on postoperative day 3 and had one brief episode of atrial fibrillation 1 week later, but has had no further atrial fibrillation for more than 6 months since the procedure.