Author + information
- Received September 19, 2011
- Revision received December 14, 2011
- Accepted December 15, 2011
- Published online July 3, 2012.
- Laurent Pison, MD⁎,⁎ (, )
- Mark La Meir, MD†,
- Jurren van Opstal, MD, PhD⁎,
- Yuri Blaauw, MD, PhD⁎,
- Jos Maessen, MD, PhD† and
- Harry J. Crijns, MD, PhD⁎
- ↵⁎Reprint requests and correspondence:
Dr. Laurent Pison, Department of Cardiology, Maastricht University Medical Center and Cardiovascular Research Institute, P.O. Box 5800, Maastricht, the Netherlands
Objectives The purpose of this study was to evaluate the feasibility, safety, and clinical outcomes up to 1 year in patients undergoing combined simultaneous thoracoscopic surgical and transvenous catheter atrial fibrillation (AF) ablation.
Background The combination of the transvenous endocardial approach with the thoracoscopic epicardial approach in a single AF ablation procedure overcomes the limitations of both techniques and should result in better outcomes.
Methods A cohort of 26 consecutive patients with AF who underwent hybrid thoracoscopic surgical and transvenous catheter ablation were followed, with follow-up of up to 1 year.
Results Twenty-six patients (42% with persistent AF) underwent successful hybrid procedures. There were no complications. The mean follow-up period was 470 ± 154 days. In 23% of the patients, the epicardial lesions were not transmural, and endocardial touch-up was necessary. One-year success, defined according to the Heart Rhythm Society, European Heart Rhythm Association, and European Cardiac Arrhythmia Society consensus statement for the catheter and surgical ablation of AF, was 93% for patients with paroxysmal AF and 90% for patients with persistent AF. Two patients underwent catheter ablation for recurrent AF or left atrial flutter after the hybrid procedure.
Conclusions A combined transvenous endocardial and thoracoscopic epicardial ablation procedure for AF is feasible and safe, with a single-procedure success rate of 83% at 1 year.
Dr. La Meir is a consultant to Atricure. Dr. Crijns receives research funding from Atricure. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received September 19, 2011.
- Revision received December 14, 2011.
- Accepted December 15, 2011.
- American College of Cardiology Foundation