Minimally Invasive Surgical Treatment Versus Medical Management for Stroke Patients With Atrial Fibrillation

Must have had a stroke or transient ischemic attack (TIA) and have Atrial Fibrillation

Inclusion Criteria:

- Patients with a history of stroke and paroxysmal, persistent or permanent AF.

- Ischemic stroke or TIA with documented paroxysmal or persistent atrial fibrillation.
A TIA will meet inclusion criteria as a sudden-onset focal neurological symptom or
sign lasting at least 10 minutes but less than 24 hours with or without evidence of
acute brain ischemia on diffusion weighted MRI imaging.

- Eligible symptoms INCLUDE hemiplegia or hemiparesis, monoplegia, or language
disturbance other than isolated dysarthria.

- Symptoms that will NOT QUALIFY AS TIA INCLUDE transient monocular blindness in both
eyes, dysarthria, vertigo,isolated sensory symptoms, confusion, memory loss,
nonspecific complaints of dizziness, or syncope.

Exclusion Criteria:

- Recent stroke (< 1 month).

- Age < 18 or > 80 years; Ejection Fraction < 25%• Presence of left atrial appendage
thrombus on CT or echocardiography

- Previous empyema or thoracic surgery, preventing access to the pulmonary veins via
thoracoscopy.

- Left Atrial Diameter > 55mm.

- Contraindication to anticoagulation with Coumadin.

- Mitral insufficiency (> 2+)

- • • Contraindications to MRI

- •Artificial heart valve prosthesis

- Aneurysm clips

- Implanted drug infusion device or pump

- Any type of neurotranstimulator

- Any type of bone growth stimulator

- Cochlear implants or inner ear prosthesis

- Any intravascular coils, filters, or stents

- Shrapnel or bullets

- Other metallic implants or devices specify which

- Permanently tattooed eyeliner

- Are you pregnant or suspect to be pregnant?