Observational studyInterdisciplinary cardiovascular and thoracic surgery2026
A Retrospective Long-Term Follow-Up of the Randomized Study: Total Endoscopic Ablation of Patients With Long-Standing Persistent Atrial Fibrillation.
Observational study in Interdisciplinary cardiovascular and thoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesMinimally invasive surgical ablation for atrial fibrillation is an alternative to catheter ablation. Achieving a lasting sinus rhythm in long-standing persistent atrial fibrillation is challenging, and long-term data after surgery are limited. In 2016, we published a randomized trial comparing totally endoscopic box lesion ablation of the left atrium (case) to medical therapy (control) during 1 year in patients with long-standing persistent atrial fibrillation. This study presents data from a follow-up of our previous cohort to investigate the rhythm outcome long-term.
methodsThis was an observational follow-up study. Most recent heart rhythm, time from totally endoscopic ablation to first relapse in atrial fibrillation, re-ablation, stroke, medication, left ventricular ejection fraction, and mortality were gathered from medical records and analysed with descriptive statistics and survival analysis.
resultsAt the end of the randomized trial, 80% of the cases had sinus rhythm without antiarrhythmic drugs. During a mean follow-up of 9 years, 43% of cases and 74% of controls had undergone additional ablation procedures (P = .009). At the last follow-up, 21% of cases and 5% of controls were in SR. After totally endoscopic ablation, the mean time from surgery to first relapse in atrial fibrillation was 23 months (14-31 [95% CI] P < .001).
conclusionsIn this population of patients with long-standing persistent atrial fibrillation, totally endoscopic box lesion ablation of the left atrium had short-term efficacy in restoring sinus rhythm. Long-term efficacy could not be demonstrated, with a high proportion of relapse in atrial fibrillation beyond 1 year post ablation.
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