Midterm outcomes of two-staged hybrid ablation of persistent and long-standing persistent atrial fibrillation using the versapolar epicardial surgical device and subsequent catheter ablation

Budera, Petr; Osmančík, Pavel; Heřman, Dalibor; Zdarska, Jana; Talavera, David Peñalver; Malá, Anna; Procházková, Radka; Straka, Zbyněk

doi:10.1007/s10840-017-0286-y

Cited by 7 publications

(2 citation statements)

References 19 publications

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“…Kress et al achieved an AF-free survival of 72% at median follow-up of 16 months (12). Other authors (13,14) achieved sinus rhythm in over 80% of the patients and resulted in substantial left atrial and left ventricular reverse remodeling, improvement in the ejection fraction, functional status, and even a decrease in the NT-pro BNP serum levels after twelve months.…”

Section: Discussionmentioning

confidence: 98%

Targeting Bachmann’s bundle in hybrid ablation for long standing persistent atrial fibrillation: a proof of concept study

Martino¹,

Nasso²,

Gasperetti

et al. 2020

Preprint

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Introduction. Catheter-based or surgical procedures in patients with long-standing persistent atrial fibrillation (LSPAF) remain a challenge. As a result, different approaches including hybrid (surgical and endocardial) ablation have been developed. Bachmann's bundle (BB) is a mainly epicardial structure capable of sustaining arrhythmic reentry that could be involved in the development and perpetuation of atrial fibrillation. We investigated the efficacy and safety of an adjunctive BB ablation in LSPAF patients undergoing hybrid ablation. Methods. In a two arm non randomized study, consecutive LSPAF patients undergoing epicardial isolation of pulmonary veins with left atrial posterior wall (box-lesion) with (n=30, BB-group) and without additional BB ablation (n=30, CONV-group) were enrolled in the study. All patients underwent an endocardial procedure within 6 weeks post-surgery to assess for potential lesion gaps and additional atrial substrate modification. The primary endpoint was freedom from AF through 12 months of follow-up. Results. The two-staged hybrid ablation was successfully completed in all patients. One-year freedom from atrial arrhythmias recurrence rates was 96.6% in the BB group vs 76.6% in the CONV group (p=0.025). At procedure completion, 30 (100%) and 17 (56%) patients had a spontaneous cardioversion in BB and CONV group respectively (p < 0.001). No significant differences in quality of life or complication rates were observed. Conclusions. This initial experience shows, for the first time, that adjunctive BB ablation in the setting of hybrid ablation for LSPAF is a feasible and effective approach in increasing maintenance of sinus rhythm without increasing complication rates.Targeting Bachmann's bundle in hybrid ablation for long standing persistent atrial fibrillation: a proof of concept study Bachmann's bundle ablation in persistent atrial fibrillation

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Section: Discussionmentioning

confidence: 98%

Targeting Bachmann’s bundle in hybrid ablation for long standing persistent atrial fibrillation: a proof of concept study

Martino¹,

Nasso²,

Gasperetti

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…RF lesion shape is dependent on a number of factors including catheter tip diameter, inter-tip spacing, tissue contact, temperature and duration of energy pulse delivered [ 25 , 26 , 27 ]. RF is a clinically significant technique as an ablation treatment for atrial fibrillation (AF), with success rates generally ranging anywhere between 45% and 80% [ 4 , 28 , 29 ].…”

Section: Current Ablation Approaches For Treating Arrhythmiamentioning

confidence: 99%

Ablation Modalities for Therapeutic Intervention in Arrhythmia-Related Cardiovascular Disease: Focus on Electroporation

McBride

Avazzadeh

Wheatley

et al. 2021

JCM

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Targeted cellular ablation is being increasingly used in the treatment of arrhythmias and structural heart disease. Catheter-based ablation for atrial fibrillation (AF) is considered a safe and effective approach for patients who are medication refractory. Electroporation (EPo) employs electrical energy to disrupt cell membranes which has a minimally thermal effect. The nanopores that arise from EPo can be temporary or permanent. Reversible electroporation is transitory in nature and cell viability is maintained, whereas irreversible electroporation causes permanent pore formation, leading to loss of cellular homeostasis and cell death. Several studies report that EPo displays a degree of specificity in terms of the lethal threshold required to induce cell death in different tissues. However, significantly more research is required to scope the profile of EPo thresholds for specific cell types within complex tissues. Irreversible electroporation (IRE) as an ablative approach appears to overcome the significant negative effects associated with thermal based techniques, particularly collateral damage to surrounding structures. With further fine-tuning of parameters and longer and larger clinical trials, EPo may lead the way of adapting a safer and efficient ablation modality for the treatment of persistent AF.

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Invasive therapies for patients with concomitant heart failure and atrial fibrillation

et al. 2019

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Midterm outcomes of two-staged hybrid ablation of persistent and long-standing persistent atrial fibrillation using the versapolar epicardial surgical device and subsequent catheter ablation

Abstract: Hybrid ablation of non-paroxysmal AF using a novel, versapolar RF device yields promising mid-term results. Better arrhythmia-free survival rates were found in AF patients with shorter AF duration.

Cited by 7 publications

References 19 publications

Targeting Bachmann’s bundle in hybrid ablation for long standing persistent atrial fibrillation: a proof of concept study

Targeting Bachmann’s bundle in hybrid ablation for long standing persistent atrial fibrillation: a proof of concept study

Ablation Modalities for Therapeutic Intervention in Arrhythmia-Related Cardiovascular Disease: Focus on Electroporation

Invasive therapies for patients with concomitant heart failure and atrial fibrillation

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