Key result
Hybrid atrial fibrillation ablation procedures combining epicardial surgical and endocardial catheter techniques show encouraging medium and long-term success rates, particularly for persistent AF.
Hybrid ablation strategies combining endocardial and surgical techniques show promise for challenging cases like persistent AF and failed prior ablations by overcoming the mutual shortcomings of each approach.
May support hybrid ablation for refractory persistent AF; hypothesis-generating and leaves open need for randomized confirmation.
Endocardial atrial fibrillation (AF) ablation techniques enable one to characterize the underlying substrate in order to tailor the ablation procedure but these ablation lesions are not always transmural nor long lasting. Surgical AF ablation techniques, on the other hand, create reliable linear lesions but the lesion set is based on empirical assumptions rather than specific patient characteristics. Performed in combination, both approaches seem to be complementary as they overcome their mutual shortcomings. Several hybrid or convergent ablation strategies with the use of various energy sources have been described. Medium and long term results are encouraging, especially in challenging settings such as persistent AF and failed endocardial catheter ablations.
No takes yet. Share an insight, caveat, or question.
M et al. (2013) conducted a review in Atrial Fibrillation. Hybrid epicardial-endocardial ablation was evaluated. Hybrid atrial fibrillation ablation procedures combining epicardial surgical and endocardial catheter techniques show encouraging medium and long-term success rates, particularly for persistent AF.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: