Why the study?
Catheter ablation has poor success in persistent or long-standing persistent AF, while surgical ablation carries sternotomy and cardiopulmonary bypass-related complications.
This article reviews primary surgical and hybrid approaches used to treat persistent or long-standing persistent atrial fibrillation.
Hybrid ablation may improve rhythm control in persistent AF; leaves open whether it is the gold standard pending RCTs.
Endocardial radiofrequency catheter ablation is considered to be a useful procedure for paroxysmal atrial fibrillation. However, catheter ablation has difficulties in achieving successful results in patients with persistent or long-standing persistent atrial fibrillation. Currently, the gold standard is surgical ablation (the Cox maze III procedure). However, because surgical ablation requires a sternotomy and extracorporeal cardiopulmonary bypass and has been associated with surgery-related complications, minimally invasive (totally thoracoscopic) and epicardial-endocardial (hybrid) ablation procedures have been developed. This article reviews the primary surgical and hybrid approaches used to treat persistent or long-standing persistent atrial fibrillation.
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Jeong et al. (2020) studied this question.
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