Midterm outcomes of mini-invasive surgical and hybrid ablation of atrial fibrillation

Pojar, Marek; Haman, Luděk; Pařízek, Petr; Myjavec, Andrej; Gofus, Ján; Vojacek, Jan

doi:10.5507/bp.2018.050

Cited by 8 publications

(10 citation statements)

References 31 publications

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“…The mean duration of AF (since diagnosis) was 67.7 ± 72 months with a mean LVEF of 55.4 ± 11%. Five studies included patients with paroxysmal AF, with the majority of studies reviewing patients with persistent and long-standing AF [ 19 , 23 , 24 , 26 , 30 ].…”

Section: Resultsmentioning

confidence: 99%

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Mid term freedom from atrial fibrillation following hybrid ablation, a systematic review and meta analysis

Eranki

Wilson-Smith

Flynn

et al. 2023

J Cardiothorac Surg

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Introduction Atrial Fibrillation (AF) is a common tachyarrhythmia affecting 33 million people worldwide. Hybrid AF ablation utilises a surgical (epicardial) ablation followed by an endocardial catheter-based ablation. The aim of this systematic review and meta-analysis is to summarize the literature reporting mid-term freedom from AF following hybrid ablation. Methods An electronic search of databases was performed to identify all relevant studies providing mid-term (2 year) outcomes following hybrid ablation for AF. The primary study outcome was to assess the mid-term freedom from AF following hybrid ablation, utilising the metaprop function on Stata® (Version 17.0, StataCorp, Texas, USA). Subgroup analysis was performed to assess the impact of various operative characteristics on mid-term freedom from AF. The secondary outcomes assessed mortality and procedural complication rate. Results The search strategy identified 16 studies qualifying for inclusion in this meta-analysis, with 1242 patients in total. The majority of papers were retrospective cohort studies (15) and one study was a randomized control trial (RCT). The mean follow up was 31.5 ± 8.4 months. Following hybrid ablation, the overall mid-term freedom from AF was 74.6% and 65.4% for patients off antiarrhythmic drugs (AAD). Actuarial freedom from AF was 78.2%, 74.2% and 73.6% at 1, 2 and 3 years respectively. No significant differences in mid-term freedom from AF based epicardial lesion set (box vs pulmonary vein isolation) or Left atrial appendage/Ganglionated Plexus/Ligament of Marshall ablation or staged vs concomitant procedures. There were 12 deaths overall following the hybrid procedure with a pooled complication rate of 5.53%. Conclusion Hybrid AF ablation offers promising mid-term freedom from AF reported at a mean follow-up of 31.5 months. The overall complication rate remains low. Further analysis of high-quality studies with randomized data and long-term follow up will help verify these results.

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Section: Resultsmentioning

confidence: 99%

“…The most common access was thorascopic (12 studies). Seven studies utilised a bilateral thorascopic approach [ 17 , 19 , 22 , 24 , 26 , 27 , 30 ]. The convergent procedure was performed in four studies via a subxiphoid laparoscopic approach [ 20 , 21 , 23 , 25 ].…”

Section: Resultsmentioning

confidence: 99%

Mid term freedom from atrial fibrillation following hybrid ablation, a systematic review and meta analysis

Eranki

Wilson-Smith

Flynn

et al. 2023

J Cardiothorac Surg

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“…Compier та співавторів після торакоскопічної радіочастотної ізоляції вічок легеневих вен за методикою box lesion біполярним електродом Cardioblate Gemini-s iRF у період спостереження (17 ± 7) місяців (мінімум 7 місяців) рецидивів ФП не було у 76 % пацієнтів без прийому антиаритмічних препаратів [4]. M. Pojar та співавтори [25] стверджують, що після лікування ФП за цією методикою в період спостереження 6 міс синусовий ритм зберігався у 90 % пацієнтів. Також, за даними різних публікацій, при використанні інших методик хірургічного лікування ізольованої ФП торакоскопічним доступом ефективність ремісії відносно ФП становить 73-86 % у період спостереження від 6 до 24 міс.…”

Section: методи лікування фібриляції передсердь у пацієнтів з клапаннunclassified

The methods of treatment of atrial fibrillation in patients with valvular heart disease

Grytsay¹,

Skybchyk²,

Mokryk³

et al. 2019

CSIC

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“…Surgical ablation equipment is used to achieve the effect of ablation line continuity and permeability, and then the catheter is used to “modify” the line and other endocardium‐triggered matrix ablations, which improves the integrity and reliability of the ablation line 3,8,11 . In recent years, many studies have explored the efficacy and safety of hybrid ablation in the treatment of patients with nonparoxysmal AF 8–10,12,13 . Considering that a single study could not provide enough evidence to guide practice, we conducted a meta‐analysis with the purpose of providing further information on the effectiveness and safety of hybrid ablation as a first‐line treatment for patients with PsAF and LSPF.…”

Section: Introductionmentioning

confidence: 99%

“…3,8,11 In recent years, many studies have explored the efficacy and safety of hybrid ablation in the treatment of patients with nonparoxysmal AF. [8][9][10]12,13 Considering that a single study could not provide enough evidence to guide practice, we conducted a meta-analysis with the purpose of providing further information on the effectiveness and safety of hybrid ablation as a first-line treatment for patients with PsAF and LSPF.…”

Section: Introductionmentioning

confidence: 99%

Hybrid ablation procedure for the treatment of nonparoxysmal atrial fibrillation: A systematic review and meta‐analysis

Hao

Yu-bao

Chen

et al. 2022

Pacing Clinical Electrophis

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Background Hybrid ablation combines the advantages of surgical and catheter ablation. Many studies have explored the efficiency and safety of hybrid ablation in patients with nonparoxysmal AF. Methods We systematically searched for prospective controlled trials that compared hybrid ablation with catheter/surgical ablation in PubMed, Web of Science, Wiley Library, and CNKI. Our main assessment indicators included maintenance of sinus rhythm (SR) without antiarrhythmic drugs for more than 12 months, major adverse events (MAEs), procedure time and fluoroscopy time. Results Of 1214 identified studies, five were eligible and were included in our analysis (N = 451 participants). The pooled results showed that hybrid ablation was more effective in maintaining SR than a single procedure (surgical ablation or catheter ablation) (OR = 2.52, 95% confidence interval [CI]: 1.63–3.89, p < .001). Little significant heterogeneity was revealed (p = .32 for heterogeneity, I2 = 14%). More MAEs occurred in the hybrid group than in the single procedure group (OR = 7.47, 95% CI: 1.90–29.41, p = .004; I2 = 0%). Two trials reported the procedure and fluoroscopy times, and the procedure time for hybrid ablation was significantly longer than that of a single procedure (mean difference = 107.42, 95% CI: 88.62 to 126.22, p < .001; I2 = 82%). There was no significant difference in fluoroscopy time between the 2 groups (mean difference = –1.00, 95% CI: –5.37 to 3.36, p = .65; I2 = 12%). Conclusions Hybrid ablation was more effective than catheter ablation and was as effective as surgical ablation in patients with nonparoxysmal AF. Meanwhile, hybrid ablation, especially concomitant hybrid ablation, increases the incidence of MAEs and prolongs the procedure time.

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Midterm outcomes of mini-invasive surgical and hybrid ablation of atrial fibrillation

Abstract: . Combination of mini-invasive surgical and endocardial treatment (two-stage hybrid procedure) is a safe and effective method for the treatment of isolated (lone) AF. This procedure provided good midterm outcomes.

Cited by 8 publications

References 31 publications

Mid term freedom from atrial fibrillation following hybrid ablation, a systematic review and meta analysis

Mid term freedom from atrial fibrillation following hybrid ablation, a systematic review and meta analysis

The methods of treatment of atrial fibrillation in patients with valvular heart disease

Hybrid ablation procedure for the treatment of nonparoxysmal atrial fibrillation: A systematic review and meta‐analysis

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