Midterm clinical outcomes of concomitant thoracoscopic epicardial and transcatheter endocardial ablation for persistent and long-standing persistent atrial fibrillation: a single-centre experience

Carlo de Asmundis, Jean-Baptiste Chierchia, Giacomo Mugnai, Ines Van Loo, Jan Nijs, Jens Czapla, Giulio Conte, Vedran Velagic, Moises Rodrigues Mañero, Giuseppe Ciconte, Erwin Ströker, Vincent Umbrain, Jan Poelaert, Pedro Brugada, Mark La Meir

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31 Citations (Scopus)

Abstract

AIMS: The purpose of this study was to analyse the efficacy and complication rates of the simultaneous hybrid procedure in a series of patients with persistent and long-standing persistent atrial fibrillation (AF) in a midterm follow-up.

METHODS AND RESULTS: Sixty-four consecutive patients (56 males, 59.7 ± 8.7 years) having undergone isolation of pulmonary veins (PVs) and posterior wall of left atrium (LA) by means of hybrid thoracoscopic ablation for symptomatic persistent (n = 21, 33%) and long-standing persistent AF (n = 43, 67%) were analysed. At a mean follow-up of 23.1 ± 14.1 months (median 21; range 6-57), the success rate without antiarrhythmic therapy was achieved in 67.2% of patients. Procedure-related complications were observed in 13 patients (20.3%) including 2 LA perforations (3.1%) requiring, respectively, conversion to sternotomy and small left-sided thoracotomy. The success rate did not significantly differ between persistent and long-standing persistent AF (respectively, 71.4 and 65.1%; P = 0.4). Patients with AF relapse during the blanking period were 4.60 times more likely to have AF recurrence after 3 months from the ablation procedure.

CONCLUSION: The hybrid procedure yields promising results in the setting of both persistent and long-standing persistent AF after midterm follow-up, at the expense of a non-negligible rate of adverse events. Our findings need to be confirmed by further larger and prospective studies.

Original languageEnglish
Pages (from-to)58-65
Number of pages8
JournalEuropace
Volume19
Issue number1
Early online date2016
DOIs
Publication statusPublished - Jan 2017

Keywords

  • Catheter ablation
  • Hybrid procedure
  • Long-standing persistent atrial fibrillation
  • Pulmonary vein isolation
  • Surgical ablation

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