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2016 ; 47
(3
): 265-274
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Hybrid ablation for atrial fibrillation: a systematic review
#MMPMID27613183
Vroomen M
; Pison L
J Interv Card Electrophysiol
2016[Dec]; 47
(3
): 265-274
PMID27613183
show ga
PURPOSE: Hybrid ablation for AF is performed in a growing number of centers. Due
to absence of guidelines, operative approaches and perioperative care differ per
center. In this review, an overview of findings from published studies on hybrid
ablations is given, and related topics are discussed (e.g., one- and two-stage
approaches, lesion sets, and patient management). METHODS: A systematic
literature search was performed in the PubMed and Embase databases. All
identified articles were screened and checked for eligibility by the two authors.
RESULTS: Twelve studies describing a total of 563 patients were selected. Due to
substantial differences in approaches (one-stage, two-stage, sequential),
surgical techniques (bilateral or monolateral thoracoscopy, subxiphoideal,
transabdominal), energy sources (unipolar, bipolar), lesion sets (applying left
or right atrial lesions), periprocedural care and endpoints (monitoring,
definition of recurrence), and success rates (sinus rhythm after a mean of
26 months) are difficult to compare and varied from 27 % (without antiarrhythmic
drugs, AADs) to 94 % (with AADs). For studies using bipolar devices, success
rates with the use of antiarrhythmic drugs were at least 71 %. Major
complications such as bleeding, sternotomy, and death occurred in 7 % of the
total population (of which ten complications, 16 %, occurred in the concomitant
cardiac surgery hybrid group). CONCLUSION: The field of AF ablation has
dramatically changed over the past years, with one of the most recent
developments the hybrid AF ablation. Lack of matching data hinders drawing
conclusions and creating guidelines. Early results however are encouraging. More
data are awaiting and needed.
|Ablation Techniques/methods/*mortality/*statistics & numerical data
[MESH]
|Adult
[MESH]
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Atrial Fibrillation/*mortality/*surgery
[MESH]
|Cardiovascular Surgical Procedures/methods/*mortality/statistics & numerical data
[MESH]
|Causality
[MESH]
|Combined Modality Therapy/methods/mortality/statistics & numerical data
[MESH]