Safety and Efficacy of a Convergent Hybrid Procedure Using Cryo as Endocardial Energy Source for the Treatment of Persistent and Longstanding Persistent Atrial Fibrillation
Key result
Convergent hybrid ablation with epicardial isolation is linked to increased success treating persistent AF.
Why the study?
Catheter-based endocardial ablation has limited efficacy for persistent and long-standing persistent atrial fibrillation, prompting evaluation of convergent hybrid procedures augmenting endocardial ablation with epicardial left atrial posterior wall isolation.
Key Points
- Investigate the safety and efficacy of a convergent hybrid procedure using cryo energy for atrial fibrillation treatment.
- Involved catheter-based endocardial ablation combined with epicardial isolation strategies.
- Measured outcomes related to treatment success and safety parameters.
- Enhanced treatment success rate observed with hybrid procedure compared to standard methods.
- Significant reduction in atrial fibrillation recurrence rates was noted.
- Improved patient outcomes with acceptable safety profiles were reported.
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Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Ablation with endocardial tools alone has been problematic for long-standing persistent AF, and this is well illustrated in multiple clinical trials. The hybrid Convergent procedure combines endocardial and epicardial ablation to achieve a more comprehensive PV and extra-PV subset ablation, with documented transmural lesions while minimising the risk of oesophageal injury.”
“A-fib is easiest to treat soon after it starts. But patients might not be bothered by short episodes of irregular rhythm and might not seek treatment. Over months or years, the A-fib becomes persistent, and this causes changes in the atria that make it harder to treat.”
Implication
Hybrid ablation may improve PersAF outcomes; leaves open need for RCTs to confirm benefit.
Abstract
Catheter-based endocardial ablation has limited efficacy for persistent and long-standing persistent atrial fibrillation (PersAF). Convergent hybrid procedures where endocardial ablation is augmented by epicardial left atrial posterior wall isolation have reported increased success. Most published
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Cite This Study
Makati et al. (2020) studied this question. Convergent hybrid procedures augmenting endocardial ablation with epicardial left atrial posterior wall isolation have reported increased success for treating persistent atrial fibrillation.