Key result
Combined surgical and endocardial AF ablation linked to just ~19% arrhythmia-free survival and higher complications.
Why the study?
Does a combined surgical epicardial and endocardial catheter ablation procedure improve outcomes and reduce complications compared to standard endocardial ablation in patients with longstanding persistent atrial fibrillation and enlarged left atrium?
Cohort (n=59)
No
Does a combined surgical epicardial and endocardial catheter ablation procedure improve outcomes and reduce complications compared to standard endocardial ablation in patients with longstanding persistent atrial fibrillation and enlarged left atrium?
Absolute Event Rate: 19% vs 54.3%
p-value: p=<0.001
In patients with longstanding persistent AF and enlarged left atria, a hybrid epicardial/endocardial ablation approach resulted in lower arrhythmia-free survival and higher complication rates compared to standard endocardial ablation.
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Hybrid ablation linked to lower success and more complications in this cohort; leaves open the role of hybrid strategies pending randomized trials.
Edgerton et al. (2016) conducted a cohort in Longstanding persistent atrial fibrillation (n=59). Combined surgical epicardial and endocardial catheter ablation (hybrid procedure) vs. Standard endocardial only ablation was evaluated on Arrhythmia-free after a single procedure, on or off antiarrhythmic drugs (p=<0.001). A combined surgical and endocardial ablation approach for longstanding persistent AF yielded lower 24-month arrhythmia-free survival (19% vs 54.3%, P<0.001) and higher complication rates (P=0.036).
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