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ONLINE APPENDIX
INCLUSION AND EXCLUSION CRITERIA. Patients could be included in the study if they
agreed to undergo thoracoscopic ablation because of persistent AF, enlarged left atria (left atrial
volume index (LAVI) >33 ml/m2, previously failed catheter ablation, or patient preference, and
had failed at least 1 class Ic or III AAD, were 18 to 80 years old, and had a life expectancy ≥2
years.
Exclusion criteria were: unable or unwilling to take AADs; catheter ablation for AF
within the preceding 4 months; myocardial infarction within the preceding 2 months;
cerebrovascular accident (any sudden neurological deficit lasting ≥24 h, with or without
pathological computed tomographic cerebrum) within the preceding 6 months; New York Heart
Association (NYHA) III/IV heart failure, NYHA II or III/IV heart failure with recent
hospitalization for decompensation (unless related to or aggravated by AF); left ventricular
ejection fraction (LVEF) <35%; documented carotid stenosis >80%; planned cardiac surgery for
other purposes than AF alone; active infection; pregnant or being of childbearing potential
without adequate anticonception; requiring AADs for ventricular arrhythmias; documentation of
an intracardiac mass or thrombus; being unable to undergo transesophageal echocardiography
(TEE); previous thoracic radiation; comorbid conditions possessing undue risks for general
anesthesia or thoracoscopic port access; or being unwilling/unable to adhere to the follow-up
protocol.
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Figure 1: Anatomical Localization of the Major Ganglion Plexi. This posterior view of the
left and right atrium displays the anatomical location of each major ganglion plexus (GP) and the
ligament of Marshall (LOM). ARGP = anterior right GP; ILGP = inferior left GP; IRGP =
inferior right GP; IVC = inferior caval vein; LIPV = left inferior PV; LSPV = left superior PV;
PA = pulmonary artery; PV = pulmonary vein; RIPV = right inferior PV; RSPV = right superior
PV; SLGP = superior left GP; SVC = superior caval vein.
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