Cor Vasa 2017, 59(4):e337-e344 | DOI: 10.1016/j.crvasa.2017.06.008

Hybrid dual stage closed chest ablation of persistent atrial fibrillation

Adam Wojtaszczyk^a, Piotr Buchta^a, Krzysztof Myrda^a, Mariusz Gąsior^a, Oskar Kowalski^c, Zbigniew Kalarus^c, Krzysztof Filipiak^b, Marian Zembala^b, Michał O. Zembala^b,*

^a 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Silesian Centre for Heart Disease in Zabrze, Poland

^b Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Silesian Centre for Heart Disease in Zabrze, Poland

^c Department of Cardiology, Congenital Heart Diseases and Electrotherapy, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Silesian Centre for Heart Disease in Zabrze, Poland

The hybrid ablation (HABL) of atrial fibrillation which combines endoscopic, minimally invasive, closed chest epicardial ablation with endocardial CARTO-guided accuracy was introduced to overcome limitations of current therapeutic options for patients with persistent (PSAF) and long-standing persistent atrial fibrillation (LSPAF). The purpose of this single-centre, prospective clinical registry was to evaluate procedural safety and feasibility as well as effectiveness of the HABL in patients with PSAF and LSPAF 1-year post-procedure. From July 2009 to December 2014, ninety (n = 90) patients with PSAF (n = 39) and LSPAF (n = 51) underwent HABL. Mean AF duration was 4.5 ± 3.7 years. At 6 months post-procedure 78% patients were in SR. At 12 months post-procedure 86% patients were in SR and 62.3% in SR and of class I/III AADs. These results suggest that combination of epicardial and endocardial RF ablation should be considered as a treatment option for patients with persistent and long-standing persistent atrial fibrillation as it is safe and effective in restoring sinus rhythm.

Keywords: Atrial fibrillation; Hybrid ablation; Pulmonary vein isolation; Surgical ablation

Received: May 16, 2017; Revised: June 13, 2017; Accepted: June 15, 2017; Published: August 1, 2017  Show citation