Key result
Robotic-assisted convergent hybrid ablation successfully restores sinus rhythm in persistent AF with severe pericardial adhesions.
Why the study?
Hybrid ablation approaches are recommended for symptomatic persistent AF resistant to standard treatments, but pericardial adhesions complicate standard epicardial access.
Does robotic-assisted hybrid ablation allow for successful treatment of persistent atrial fibrillation in patients with diffuse pericardial adhesions?
Case Report (n=1)
Does robotic-assisted hybrid ablation allow for successful treatment of persistent atrial fibrillation in patients with diffuse pericardial adhesions?
Robotic-assisted hybrid ablation provides a novel and effective approach for managing long-standing persistent atrial fibrillation, particularly in patients with diffuse pericardial adhesions where standard epicardial approaches are precluded.
Answers are grounded in this paper and cite their sources.
May offer feasible option in re-do AF with adhesions; hypothesis-generating and leaves open questions on safety and efficacy.
BACKGROUND: Atrial fibrillation (AF), the most prevalent arrhythmia, poses significant health risks globally, particularly in aging populations. For symptomatic persistent AF resistant to standard treatments, the guidelines recommend hybrid approaches. Convergent hybrid ablation with robotic epicardial surgery enhances access in cases with challenging pericardial adhesions. CASE SUMMARY: We present a case of persistent AF with past catheter ablation complicated by pericardial effusion now presenting with worsening symptoms. Given anticipated pericardial adhesions, convergent hybrid ablation with a robotic-assisted epicardial component was performed, followed by a successful second-stage endocardial ablation. The patient had an uneventful recovery and remains in sinus rhythm. DISCUSSION: This report demonstrates the successful application of a robotic platform to the epicardial component of a Convergent hybrid ablation procedure, in which diffuse adhesions precluded the standard approach. TAKE-HOME MESSAGE: Robotic-assisted hybrid ablation is a novel approach for hybrid ablation for long-standing persistent AF, especially in patients with pericardial adhesions.
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Hung et al. (2026) conducted a case report in Persistent atrial fibrillation with pericardial adhesions (n=1). Convergent hybrid ablation with a robotic-assisted epicardial component and second-stage endocardial ablation was evaluated on Recovery and maintenance of sinus rhythm. Robotic-assisted convergent hybrid ablation was successfully performed in a patient with persistent atrial fibrillation and diffuse pericardial adhesions, resulting in maintenance of sinus rhythm.
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