Hybrid surgical ablation for persistent or long standing persistent atrial fibrillation: A French single centre experience

Ann Cardiol Angeiol (Paris). 2020 Apr;69(2):86-92. doi: 10.1016/j.ancard.2020.03.008. Epub 2020 Mar 30.

Abstract

Background: Hybrid ablation for the treatment of atrial fibrillation is a single combined procedure consisting in a minimally thoracoscopic surgical ablation followed by a catheter ablation. This promising technique is recommended in persistent atrial fibrillation according to the current guidelines but is not routinely performed in France, mainly due to the absence of reimbursement by the French National Health Insurance.

Aims: The aim of this prospective and single-centre study was to analyse, for the first time in France, the feasibility, efficacy and complication rates of hybrid ablation in patients with persistent atrial fibrillation.

Methods: Hybrid ablation was performed in 15 consecutive patients (13 men, mean age 61±6 years) with persistent (7 patients) or long standing persistent (8 patients) atrial fibrillation.

Results: Hybrid ablation was completed in 14/15 patients. Eleven patients returned in sinus rhythm during the procedure. Two patients (13%) had major per-procedural complications and 2 had minor complications. During an average follow-up of 25±6 months, 6 patients (40%) underwent a redo catheter ablation because of atrial tachycardia, mainly peri-mitral atrial flutter. At 1 year follow up, 14/15 patients were in sinus rhythm, including 11 free of antiarrhythmic drugs.

Keywords: Ablation hybride; Fibrillation auriculaire persistante; Hybrid ablation; Persistent AF.

MeSH terms

  • Aged
  • Anti-Arrhythmia Agents / therapeutic use
  • Atrial Fibrillation / drug therapy
  • Atrial Fibrillation / surgery*
  • Catheter Ablation* / adverse effects
  • Catheter Ablation* / statistics & numerical data
  • Combined Modality Therapy / adverse effects
  • Combined Modality Therapy / methods
  • Feasibility Studies
  • Female
  • France
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Prospective Studies
  • Reoperation
  • Thoracoscopy* / adverse effects
  • Thoracoscopy* / statistics & numerical data

Substances

  • Anti-Arrhythmia Agents