Introduction
Atrial fibrillation is the most common type of persistent arrhythmia. In addition to causing palpitations and discomfort, the onset of atrial fibrillation increases the risk of thromboembolism (1). Evidence reported in the literature both at home and abroad indicates that thrombosis from the left atrial appendage is the main cause of stroke in atrial fibrillation (2). Multiple observational studies indicate the feasibility and safety of surgical LAA occlusion/exclusion(3,4). Surgical occlusion techniques include excision, stapler removal and running sutures, and with more recent technological advances, occlusion via innovative devices such as AtriClip and TigerPaw (5). However, the above methods cannot completely isolate the LAA. Some of these operations may have thrombosis complications in the long term(6). Some of them need to be operated after cardiac arrest by extracorporeal circulation, and this surgical method has a high risk of bleeding and is difficult to stop the bleeding. Therefore, we chose to perform thoracoscopic radiofrequency ablation of atrial fibrillation and implant the left atrial appendage occluder through the epicardial pathway.