Author + information
- Daniel Kaiser,
- Carrie Pierce,
- Shelby Burk,
- L. Bing Liem,
- Peter Chang Sing and
- Gansevoort Dunnington
Background: Compared to patients with paroxysmal atrial fibrillation (AF), patients with long-standing persistent (LSP) AF have disappointing outcomes with catheter ablation alone with reported success rates less than 50% at 1 year. The hybrid ablation procedure consisting of minimally invasive VATS Maze followed by catheter ablation may be a viable alternative.
Methods: From March 2013 to June 2016, we prospectively collected data on all patients who underwent hybrid ablation. We collected baseline characteristics, procedural complication and long-term freedom from AF both on and off anti-arrhythmic drug (AAD) therapy.
Results: There were 264 patients (age 67±8.3, 76% male) who underwent VATS Maze hybrid ablation. The CHADS-VASc was 2.6±1.4 with AF duration of 5.7 ±5.4 years. The incidence of paroxysmal, persistent and LSP AF was 4%, 38% and 58%. Major complications occurred in 14 (5.3%) patients, including 2 conversions to open sternotomy (0.8%), 1 stroke (0.4%) and 2 deaths (0.8%). In sinus, 6 (2.3%) required pacemakers. Overall follow-up was 80%. Of these, over 80% had ambulatory monitoring (>7 days). At 1 year, overall freedom from AF on and off AAD was 91.0% and 84.7%, which was influenced by AF type and follow-up (Figure).
Conclusions: In one of the largest cohorts to date, the VATS Maze hybrid ablation maintained freedom of AF in over 80% of patients at 1 year, including patients with LSP AF. The hybrid Maze is a promising treatment option in patients less likely to benefit from catheter ablation alone.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Atrial Fibrillation and VT: Specific Situations and Newer Outcome Measures
Abstract Category: 8. Arrhythmias and Clinical EP: Supraventricular/Ventricular Arrhythmias
Presentation Number: 1190-110
- 2017 American College of Cardiology Foundation