Why the study?
Does a hybrid thoracoscopic and transvenous catheter ablation approach improve AF-antiarrhythmic drug-free success rates compared to isolated procedures in patients with stand-alone atrial fibrillation?
Does a hybrid thoracoscopic and transvenous catheter ablation approach improve AF-antiarrhythmic drug-free success rates compared to isolated procedures in patients with stand-alone atrial fibrillation?
Hybrid epicardial and endocardial ablation shows promising success rates for stand-alone atrial fibrillation, though large multicenter trials are still needed to establish it as a gold standard.
Hypothesis-generating for hybrid ablation in stand-alone AF; leaves open confirmation in large multicenter RCTs.
The hybrid approach combines an epicardial ablation with a percutaneous endocardial ablation in a single-step or sequential procedure. This study provides an overview of the hybrid procedure for the treatment of stand-alone atrial fibrillation (AF). Papers selected for this review were identified on PubMed and the final selection included nine studies. The total number of patients was 335 (range 15-101). Mean age ranged from 55.2 to 62.9 years. The hybrid approach achieved satisfactory results, with AF-antiarrhythmic drug-free success rates higher than those in isolated procedures. In particular, the bilateral approach with a bipolar device showed a high success rate independently of the AF type and seems to be the better choice for the hybrid procedure. Despite good preliminary results, large, multicentre trials of hybrid AF ablation that target a population of patients with long-standing persistent disease are necessary to establish whether this approach may represent, in the future, a gold-standard treatment for AF.
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Gelsomino et al. (2013) studied this question.
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