Hybrid atrial fibrillation ablation: long-term outcomes from a single-centre 10-year experience

Pannone, Luigi; Mouram, Sahar; Rocca, Domenico G. Della; Sorgente, Antonio; Monaco, Cinzia; Monte, Alvise Del; Gauthey, Anaïs; Bisignani, Antonio; Kronenberger, Rani; Paparella, Gaetano; Ramak, Robbert; Overeinder, Ingrid; Bala, Gezim; Almorad, Alexandre; Ströker, Erwin; Sieira, Juan; Brugada, Pedro; Chierchia, Gian Battista; Meir, Mark La; Asmundis, Carlo de

doi:10.1093/europace/euad114

Cited by 8 publications

(2 citation statements)

References 35 publications

(34 reference statements)

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“…In a recent meta-analysis Eranki et al showed freedom from AF of 78.2% and 73.6% at 1 and 3 years after CP respectively (16). In the latest study Pannone et al reported ATs free survival without AADs in non-paroxysmal AF 76.7% at 12 months, 67.5% at 24 months, 60.5% at 36 months, 53.6% at 48 months, and 46.1% at 60 months (17).…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcome after Convergent Procedure for Atrial Fibrillation

Gersak,

Podlogar,

Kalinsek

et al. 2023

Preprint

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BackgroundThe aim of this single-center retrospective study is to evaluate the long-term outcome after convergent procedure (CP) for patients with paroxysmal atrial fibrillation (AF), persistent AF and long-standing persistent AF.Methods and resultsWe analyzed outcomes of patients that underwent CP from January 2009 until July 2020. 119 patients with paroxysmal AF (23.5%), persistent AF (5.9%) or long-standing persistent AF (70.6%) that attended long-term follow up were included. The outcome was assessed at 1-year after CP and at long-term follow up. At 1-year follow up rhythm and daily AF burden were assessed for patients with implantable loop recorder (61.2%). For others rhythm was assessed by clinical presentation and 12-lead ECG recording. At long-term follow up patients having sinus rhythm or unclear history of AF were monitored with 7-day ECG Holter and AF burden was determined. Long-term success was defined as freedom from AF/atrial flutter (AFL) with sinus rhythm on 12-lead ECG recording and AF/AFL burden <1% on 7-day Holter ECG. Repeat catheter ablations (RFA) prior to long-term follow up were documented.At 1-year follow up 91.4% of patients had sinus rhythm and 76.1% of patients had AF/AFL burden <1%. At long-term follow up (8.3 ± 2.8 years) 65.5% of patients had sinus rhythm and 53.8% patients had AF/AFL burden <1% on 7-day holter ECG. Additional RFAs were performed in 32.8% of patients who had AF or AFL burden <1%. At long-term follow up age, body mass index and left atrial volume index were associated with increased risk of AF recurrence.ConclusionsCP resulted in high long-term probability of sinus rhythm maintenance. During long-term follow-up additional RFAs were required to maintain sinus rhythm in a substantial number of patients.

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Section: Discussionmentioning

confidence: 99%

Long-Term Outcome after Convergent Procedure for Atrial Fibrillation

Gersak,

Podlogar,

Kalinsek

et al. 2023

Preprint

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“…In this case endocardial mapping and ablation at first hybrid procedure is of utmost clinical importance. 18 …”

Section: Discussionmentioning

confidence: 99%

Redo procedures after sinus node sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia

de Asmundis,

Marcon,

Pannone

et al. 2023

Europace

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Aims A novel sinus node (SN) sparing hybrid ablation for inappropriate sinus node tachycardia (IST)/Postural Orthostatic Tachycardia Syndrome (POTS) has been demonstrated to be an effective and safe therapeutic option in patients with symptomatic drug-resistant IST/POTS. The aim of this study was to evaluate the long-term rate of redo procedures after hybrid IST ablation and procedural strategy, outcomes and safety of redo procedures. Methods All consecutive patients from 2015 to 2023 were prospectively enrolled in the UZ Brussel monocentric IST/POTS registry. They were analyzed if the following inclusion criteria were fulfilled: 1) Diagnosis of IST or POTS; 2) symptomatic IST/POTS refractory or intolerant to drugs; 3) Hybrid SN sparing ablation performed. The primary endpoint was redo procedure. The primary safety endpoint was pacemaker (PM) implantation. Results A total of 220 patients undergone to hybrid IST ablation were included, 185 patients (84.1%) were treated for IST and 61 patients (27.7%) for POTS. After a follow-up of 73.3 ± 16.2 months, 34 patients (15.4%) underwent a redo. A total of 23 patients (67.6%) had a redo for IST recurrence and 11 patients (32.4%) for other arrhythmias. PM implantation was performed in 21 patients (9.5%). Nine patients (4.1%) had no redo procedure and experienced sick sinus syndrome requiring a PM. Twelve patients (5.4%) received a PM as a shared therapeutic choice combined with SN ablation procedure. Conclusion In a large cohort of patients the long-term free survival from redo procedure after hybrid IST ablation was 84.6% with a low PM implantation rate.

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