233 Mid-Term Results of Hybrid Atrial Fibrillation Ablation for Persistent Atrial Fibrillation.

Introduction: Hybrid epicardial and endocardial ablation has been proven to be an effective method for attaining rhythm control in persistent atrial fibrillation where anti-arrhythmic drug therapy and lone catheter ablation has been disappointing. We present mid-term findings on the safety and effectiveness of hybrid ablation in persistent atrial fibrillation. Method(s): Between 2017 and 2019, nineteen patients with persistent atrial fibrillation underwent totally thoracoscopic radiofrequency ablation with pulmonary vein isolation, posterior left atrial box lesion and left atrial appendage exclusion with Atriclip. They subsequently underwent endocardial mapping three months later. Any gaps from epicardial ablation were re-ablated. All patients were followed up prospectively. Result(s): Mean age of patients was 59.8+/-6.8 years. Median time of duration of atrial fibrillation preoperatively was 24 months. The average number of failed DCRs was 2.1+/-1.1. Average left atrial volume index was 55.45+/-11.5mL/m2. Average LVEF was 50.8+/-7.3%. At a mean follow-up of 395 days post hybrid ablation, all patients were in sinus rhythm at their most recent follow-up. 21% of patients had a recurrence of atrial arrhythmias. One patient had a minor complication of a left sided pleural effusion after the epicardial ablation. One patient had a pericardial effusion without tamponade requiring pericardiocentesis after epicardial ablation. There were no deaths, conversion to median sternotomy, strokes or pacemaker implantation. Conclusion(s): Sequential hybrid ablation for persistent atrial fibrillation is safe and effective.Copyright © 2020
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