Minimally invasive surgical treatment of lone atrial fibrillation: early results of hybrid versus standard minimally invasive approach employing radiofrequency sources
Abstract
Background We compared short-term results of a hybrid versus a standard surgical bilateral thoracoscopic approach employing radiofrequency (RF) sources in the surgical treatment of lone atrial fibrillation (LAF).Methods Between January 2008 and July 2010 sixty-three consecutive patients with LAF underwent minimally invasive surgery. Thirty-five (55.5%) underwent surgery with the hybrid approach whereas 28 (45.5%) underwent bilateral thoracoscopic standard procedure (no-hybrid group). All patients underwent continuous 7-day Holter Monitoring (HM) at 3 months, 6 months and 1 year.Results At 1 year, 91.4% and 82.1% (time-related prevalence 5.2% vs.6.0% [p=0.56]) of the patients were free of AF and AAD. The hybrid group yielded better results in long standing persistent AF (8.2% [time related prevalence 81.8% vs. 44.4%, p=0.001] vs.14.9%, p=0.04). One-year success rates were 87.5% vs. 100% (p=0.04) in persistent [time related prevalence 3.8% vs. 0%, p<0.001] and 87.5% vs. 100% (p=0.04) in paroxysmal AF [time related prevalence 3.2% vs. 0%, p<0.001] in the two groups. One-year prevalence of Warfarin use was significantly higher in the hybrid group (29.0% [26.2-33.1] and 13.4% [9.9-16.3]) with no difference by AF type. LA reverse remodeling occurred in 81.7% (n=30) of hybrid patients and 67.8% (n=19) of no-hybrid patients at latest control (p=0.02). Left atrial emptying fraction increased in both groups (50 ± 14%, p<0.001 and 52 ± 12%, p=0.004 in hybrid and no-hybrid, respectively) without differences between groups (p=0.6).Conclusions The hybrid procedure yielded excellent results in long-standing persistent AF. Our findings need to be confirmed by further larger studies.
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Preliminary experience with hybrid simultaneous ablation shows promise, but procedural time and rates of bleeding complications are higher.
“Although preliminary experience with hybrid simultaneous ablation shows promise, procedural time and rates of bleeding complications are higher.812, 823”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [823]
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2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418 · see citing works
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
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- Authors
- La Meir, M., Gelsomino, S., Lucà, F., Pison, L., Parise, O., Colella, A., Gensini, G. F., Crijns, H., Wellens, F., & Maessen, J. G.
- Affiliations
- Maastricht University Medical Centre (NL)
- Azienda Ospedaliero-Universitaria Careggi (IT)
- Universitair Ziekenhuis Brussel (BE)
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2013-08
- Volume
- 167
- Issue
- 4
- Pages
- 1469-1475
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W2071209713
- Cited by
- 90
- References
- 32
- Citations by year
- 2026: 1 · 2024: 5 · 2023: 4 · 2022: 4 · 2021: 5 · 2020: 3 · 2019: 5 · 2018: 5 · 2017: 18 · 2016: 14 · 2015: 8 · 2014: 9 · 2013: 6 · 2012: 3
- FWCI
- 5.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion)
- Florence Research (University of Florence) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- Funders
- American Heart Association
- European Society of Cardiology
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- lone atrial fibrillation, radiofrequency catheter ablation, long-standing persistent atrial fibrillation, paroxysmal atrial fibrillation, atrial fibrillation recurrence, left atrial reverse remodeling, left atrial ejection fraction, antiarrhythmic drugs, Holter monitoring
- MeSH terms
- Aged, Atrial Fibrillation, Female, Follow-Up Studies, Humans, Male, Middle Aged, Treatment Outcome, Catheter Ablation, Practice Guidelines as Topic, Echocardiography, Doppler, Pulsed, Minimally Invasive Surgical Procedures
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