Key result
Hybrid atrial fibrillation ablation resulted in a 47.5% freedom from atrial tachyarrhythmia recurrence at approximately 5 years, with no difference between first and redo procedures (P=0.53).
Why the study?
Hybrid AF ablation is promising in non-paroxysmal AF, but long-term outcomes after both an initial and redo procedure needed assessment in a large cohort.
Does hybrid atrial fibrillation ablation provide long-term freedom from atrial tachyarrhythmias in patients with predominantly non-paroxysmal AF?
Cohort (n=120)
No
Does hybrid atrial fibrillation ablation provide long-term freedom from atrial tachyarrhythmias in patients with predominantly non-paroxysmal AF?
p-value: p=0.53
Hybrid AF ablation provides a 47.5% freedom from atrial tachyarrhythmia recurrence at 5 years, with similar outcomes whether performed as a first or redo procedure.
ATas recurrence exceeds 50% at 5 years after hybrid AF ablation; leaves open questions on durability and optimal patient selection pending randomized data.
AIMS: Hybrid atrial fibrillation (AF) ablation is a promising approach in non-paroxysmal AF. The aim of this study is to assess the long-term outcomes of hybrid ablation in a large cohort of patients after both an initial and as a redo procedure. METHODS AND RESULTS: All consecutive patients undergoing hybrid AF ablation at UZ Brussel from 2010 to 2020 were retrospectively evaluated. Hybrid AF ablation was performed in a one-step procedure: (i) thoracoscopic ablation followed by (ii) endocardial mapping and eventual ablation. All patients received PVI and posterior wall isolation. Additional lesions were performed based on clinical indication and physician judgement. Primary endpoint was freedom from atrial tachyarrhythmias (ATas). A total of 120 consecutive patients were included, 85 patients (70.8%) underwent hybrid AF ablation as first procedure (non-paroxysmal AF 100%), 20 patients (16.7%) as second procedure (non-paroxysmal AF 30%), and 15 patients (12.5%) as third procedure (non-paroxysmal AF 33.3%). After a mean follow-up of 62.3 months ± 20.3, a total of 63 patients (52.5%) experienced ATas recurrence. Complications occurred in 12.5% of patients. There was no difference in ATas between patients undergoing hybrid as first vs. redo procedure (P = 0.53). Left atrial volume index and recurrence during blanking period were independent predictors of ATas recurrence. CONCLUSION: In a large cohort of patients undergoing hybrid AF ablation, the survival from ATas recurrence was 47.5% at ≈5 years follow-up. There was no difference in clinical outcomes between patients undergoing hybrid AF ablation as first procedure or as a redo.
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Pannone et al. (2023) conducted a cohort in Atrial fibrillation (n=120). Hybrid atrial fibrillation ablation vs. Redo procedure was evaluated on Freedom from atrial tachyarrhythmias (ATas) (p=0.53). Hybrid atrial fibrillation ablation resulted in a 47.5% freedom from atrial tachyarrhythmia recurrence at approximately 5 years, with no difference between first and redo procedures (P=0.53).
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