Hybrid atrial fibrillation ablation

Abstract

In this state-of-the art review on hybrid atrial fibrillation (AF) ablation, we briefly focus on the pathophysiology of AF, the rationale for the hybrid approach, its technical aspects and the efficacy and safety outcomes after hybrid AF ablation, both from meta-analyses and randomized control trial data. Also, we performed a systematic search to provide a provisional overview of real-world hybrid AF ablation efficacy and safety outcomes. Furthermore, we give an insight into the ‘Maastricht approach’, an approach that allows us to tailor the ablation procedure to the individual patient. Finally, we reflect on future perspectives with the objective to continue improving our thoracoscopic hybrid AF ablation approach. Based on the review of the available literature, we believe it is fair to state that thoracoscopic hybrid AF ablation is a valid alternative to catheter ablation for the treatment of patients with more persistent forms of AF.

Temporary sinus node dysfunction following ablation of atrial fibrillation in patients with aberrancy of the sinus node artery: a case series

“…Given that an aberrant SNA is potentially at risk for SND, the question arises concerning whether one should perform an additional roof line to complete the box lesion in patients with AF with preoperatively diagnosed aberrant SNA. The posterior wall of the left atrium plays an important role in the perpetuation of AF to maintain SR [ 6 ]. Although patients with an aberrant SNA suffered pre- and postoperative temporary SND in our series, they all had full recovery of sinus node function after 3 months of follow-up.…”

The predictive value of CHA2DS2-VASc score on the prognosis of patients with atrial fibrillation based on a prospective cohort study

“…The clinical consequences of AF include embolism, heart failure, and early death ( 1 ), as well as an up-to-fivefold increase in the risk of cerebral infarction. Cerebral infarction associated with AF leads to more severe disability and mortality, in addition to an increased risk of cardiovascular complications and all-cause mortality ( 2 , 3 ). Cerebral embolism, which contributes to ischemic stroke and cognitive decline, accounts for 25% to 30% of all acute ischemic stroke cases ( 4 ).…”