Middle-term results of hybrid atrial fibrillation ablation using AtriCure system

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216224%3A14110%2F17%3A00098097" target="_blank" >RIV/00216224:14110/17:00098097 - isvavai.cz</a>

Result on the web

<a href="http://dx.doi.org/10.1016/j.crvasa.2017.05.004" target="_blank" >http://dx.doi.org/10.1016/j.crvasa.2017.05.004</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.crvasa.2017.05.004" target="_blank" >10.1016/j.crvasa.2017.05.004</a>

Result language

angličtina

Original language name

Middle-term results of hybrid atrial fibrillation ablation using AtriCure system

Original language description

Introduction: Long-term results of catheter ablation (CA) for persistent and long-standing persistent atrial fibrillation (AF) are disappointing. The hybrid approach is currently one of options for overcoming the limitations of CA. Aim: To evaluate the safety and medium-term efficacy of the hybrid approach in patients with persistent and long-standing persistent AF. Methods: All patients underwent epicardial thoracoscopic radiofrequency (RF) pulmonary vein (PV) isolation using the AtriCure clamp followed by left atrial (LA) linear lesions (using a linear pen), Marshall ligament disruption, and LA appendage exclusion using an Atriclip. All patients underwent an electrophysiological study (EPS) and RF CA 2-3 months after the initial surgery to eliminate recurrent conductions from/to the PVs or across the linear lesions, and to eliminate all spontaneous and inducible atrial arrhythmias. 7-Day ECG Holter monitoring was performed every 3 months during the first year and every 6 months afterwards to evaluate possible recurrent arrhythmias. Results: Seventy patients (49 male, median 63.5 years) took part in the study. EPS was performed 87 days (median) after the thoracoscopic surgery. Seventy-six percent of patients were in normal sinus rhythm (SR) at the start of the EPS, 7% had typical atrial flutter, 11% had atrial tachycardia, and 6% were in AF. After completion of the hybrid approach, all PVs were isolated, while a complete conduction block across the linear lines was achieved in 88.6% of patients. Twelve months after the procedure, 77.1% of patients had a stable SR without any anti-arrhythmic medication or re-ablation. If we included those on anti-arrhythmic drugs and re-ablation procedures, SR was achieved in 96.5% of patients during follow-up (936 +/- 432 days). Conclusion: The sequential hybrid approach is probably the most effective and relatively safe invasive treatment for persistent and long-term persistent AF with very low medium- to long-term recurrences. Introduction of the hybrid approach to clinical practice requires extensive cooperation between cardiologic and cardiothoracic teams. (C) 2017 The Czech Society of Cardiology. Published by Elsevier Sp. zo.o. All rights reserved.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2017

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Cor et Vasa

ISSN

0010-8650

e-ISSN

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Volume of the periodical

59

Issue of the periodical within the volume

4

Country of publishing house

NL - THE KINGDOM OF THE NETHERLANDS

Number of pages

8

Pages from-to

„E345“-„E352“

UT code for WoS article

000410033600011

EID of the result in the Scopus database

2-s2.0-85020176511