Unilateral left-sided hybrid ablation for atrial fibrillation achieved a 67% probability of freedom from supraventricular tachyarrhythmia recurrence at 24 months.
Cohort
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Does unilateral left-sided hybrid ablation provide effective rhythm control and safety in patients with atrial fibrillation?
Unilateral left-sided hybrid ablation is an efficacious and safe approach for treating paroxysmal and persistent atrial fibrillation, achieving 67% freedom from recurrence at 24 months.
BACKGROUND: Hybrid ablation (HA) of atrial fibrillation (AF) combines minimally invasive thoracoscopic epicardial ablation with transvenous endocardial electrophysiologic validation and touch-up of incomplete epicardial lesions if needed. While studies have reported on a bilateral thoracoscopic HA approach, data on a unilateral left-sided approach are scarce. AIM: To evaluate the efficacy and safety of a unilateral left-sided thoracoscopic approach. METHODS: Retrospective analysis of a prospectively gathered cohort of all consecutive patients undergoing a unilateral left-sided HA for AF between 2015 and 2018 in the Maastricht University Medical Centre. RESULTS: -VASc Score 2 1-3, longstanding-persistent AF 71%, previous catheter ablation 44%). In all patients, a unilateral left-sided HA consisting of pulmonary vein (PV) isolation, posterior left atrial (LA) wall isolation, and LA appendage exclusion was attempted. Epicardial (n = 59) and/or endocardial validation (n = 81) was performed and endocardial touch-up was performed in 33 patients. Major peri-operative complications occurred in 5% of all patients. After 12 and 24 months, the probability of being free from supraventricular tachyarrhythmia recurrence was 80% 73-87 and 67% 58-76, respectively, when allowing antiarrhythmic drugs. CONCLUSION: Unilateral left-sided hybrid AF ablation is an efficacious and safe approach to treat patients with paroxysmal and (longstanding) persistent AF. Future studies should compare a unilateral with a bilateral approach to determine whether a left-sided approach is as efficacious as a bilateral approach and allows for less complications.
Heijden et al. (Wed,) conducted a cohort in Atrial fibrillation. Unilateral left-sided hybrid ablation was evaluated on Freedom from supraventricular tachyarrhythmia recurrence at 24 months (95% CI 58-76). Unilateral left-sided hybrid ablation for atrial fibrillation achieved a 67% probability of freedom from supraventricular tachyarrhythmia recurrence at 24 months.
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