ArticleInternational journal of cardiology. Heart & vasculature2020
European multicentre experience of staged hybrid atrial fibrillation ablation for the treatment of persistent and longstanding persistent atrial fibrillation.
Article in International journal of cardiology. Heart & vasculature, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 20 citations in OpenAlex.
- Phrenic nerve palsy during cryoballoon ablation of atrial fibrillation: a minor complication or a wolf in sheep's clothing? Insights on late arrhythmia recurrences from a propensity score-matched analysis.Frontiers in cardiovascular medicine · 2025Article
- Narrative Review: Surgical and Hybrid Management of Atrial Fibrillation.Cardiology and therapy · 2024Review
- Hybrid ablation for persistent atrial fibrillation: a narrative review.Journal of thoracic disease · 2024Review
- Hybrid ablation of atrial fibrillation: A unilateral left-sided thoracoscopic approach.Journal of cardiac surgery · 2022Article
- Mapping Atrial Fibrillation After Surgical Therapy to Guide Endocardial Ablation.Circulation. Arrhythmia and electrophysiology · 2022Article
- Long-Term Results of Pulmonary Vein Isolation Plus Modified Posterior Wall Debulking Utilizing High-Power Short-Duration Strategy: An All-Comers Study in Real World.Anatolian journal of cardiology · 2022Observational
- Persistent phrenic nerve palsy after atrial fibrillation ablation: Follow-up data from The Netherlands Heart Registration.Journal of cardiovascular electrophysiology · 2022Article
- Comparison between biparietal bipolar and uniparietal bipolar radio frequency ablation techniques in a simultaneous procedural setting.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2021Article
- A narrative review of hybrid ablation for persistent and longstanding persistent atrial fibrillation.Annals of translational medicine · 2021Review
- The importance of bipolar bidirectional radiofrequency in surgical AF ablation.International journal of cardiology. Heart & vasculature · 2020Article
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11 authors at 4 institutions in 3 countries.
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No grant is acknowledged in the PubMed record.
Abstract
The management of non-paroxysmal atrial fibrillation (AF) remains controversial. We examined the efficacy and safety of the 2 stage Hybrid AF ablation approach by analysing the largest series of this technique reported so far.
methodsThe approach aims to electrically isolate the left atrial posterior wall incorporating the pulmonary veins ('box-set'pattern). An initial video-assisted thoracoscopic (VATS) epicardial ablation is followed after a minimum of 8 weeks by endocardial radiofrequency catheter ablation.
resultsOf 175 patients from 4 European cardiothoracic centers, who underwent the surgical (COBRA Fusion, AtriCure Inc) 1st stage ablation, 166 went on to complete 2nd stage catheter ablation. At median follow up of 18 months post 2nd stage procedure 93/166 (56%) had remained free of AF or atrial tachycardia (AT) recurrence off antiarrhythmic drugs. 110/175 62.9% were in sinus rhythm off all antiarrhythmic drugs at last clinic follow-up (132/175 75.4% including those on antiarrhythmic drugs). 18 patients (10.8%) underwent a further re-do ablation (mean of 1.1 ablations per patient) 105/166 (63%) remained free of AF/AT recurrence off antiarrhythmic drugs following last ablation procedure.Latterly, ILRs have been implanted in patients (n = 56); 60% have remained fully arrhythmia free and 80% have shown AF burden < 5% at a median 14 months follow-up [IQR: 13.5 (8-21.5)]. Only 10.9% have reverted to persistent AF. 5 patients (2.9%) had a perioperative stroke and 4 patients (2.3%) exhibited persistent weakness of the right hemidiaphragm following stage 1 VATS epicardial ablation. One patient died following stroke (overall mortality 0.6%).
conclusionsIn patients with non-paroxysmal AF with unfavourable characteristics for catheter ablation, the staged hybrid approach results in acceptable levels of freedom from recurrent atrial arrhythmia, however, complication rates are higher than with catheter ablation alone.
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