Background: Variable outcomes exist following endocardial ablation (endo) in medically refractory persistent atrial fibrillation (AF) patients. A hybrid epicardial-endocardial approach (hybrid) has emerged as an alternative to endocardial ablation. This retrospective feasibility study aimed to assess outcomes.
Methods: In 133 consecutive patients, 69 received endocardial ablation alone (pulmonary vein isolation and radiofrequency [RF] ablation), and 64 received both endo and epicardial ablation of the posterior left atrial wall using a subxyphoid approach with irrigated RF. Recurrence was defined as any arrhythmia following the 3-month blanking period.
Results:Patients were followed for a median (Q1,Q3) of 16 (12,24) months. Hybrid and endo groups were similar in mean (±SD) age (61±10 vs 62±8) years, body mass index (35±6 vs 35±7), CHA2D2-VASc (2±1 vs 2±1) and ejection fraction (54±11 vs 53±8, %). Hybrids had a longer AF duration (months) [12 (8,28) vs 7 (5,12), p
Conclusions: Among persistent AF patients, hybrid ablation is associated with less AF recurrence. Further prospective randomized trials are needed to validate these results.
Sra J, Zilinski J, Choudhuri I, et al. Comparative Effectiveness Of Hybrid Ablation Versus Endocardial Ablation Alone In Patients With Persistent Atrial Fibrillation: A Retrospective Analysis. Journal of the American College of Cardiology. 2016; 67(13S):714-714.