Minimally invasive surgical treatment of lone atrial fibrillation: Early results of hybrid versus standard minimally invasive approach employing radiofrequency sources

Mark La Meir, Sandro Gelsomino, Fabiana Lucà, Laurant Pison, Orlando Parise, Andrea Colella, Gian Franco Gensini, Harry Crijns, Francis Wellens, Jos G. Maessen

Research output: Contribution to journalArticlepeer-review

Abstract

Background: We compared short-term results of a hybrid versus a standard surgical bilateral thoracoscopic approach employing radiofrequency (RF) sources in the surgical treatment of lone atrial fibrillation (LAF). Methods: Between January 2008 and July 2010 sixty-three consecutive patients with LAF underwent minimally invasive surgery. Thirty-five (55.5%) underwent surgery with the hybrid approach whereas 28 (45.5%) underwent bilateral thoracoscopic standard procedure (no-hybrid group). All patients underwent continuous 7-day Holter Monitoring (HM) at 3 months, 6 months and 1 year. Results: At 1 year, 91.4% and 82.1% (time-related prevalence 5.2% vs.6.0% [p = 0.56]) of the patients were free of AF and AAD. The hybrid group yielded better results in long standing persistent AF (8.2% [time related prevalence 81.8% vs 44.4%, p = 0.001] vs.14.9%, p = 0.04). One-year success rates were 87.5% vs 100% (p = 0.04) in persistent [time related prevalence 3.8% vs 0%, p <0.001] and 87.5% vs 100% (p = 0.04) in paroxysmal AF [time related prevalence 3.2% vs 0%, p <0.001] in the two groups. One-year prevalence of Warfarin use was significantly higher in the hybrid group (29.0% [26.2-33.1] and 13.4% [9.9-16.3]) with no difference by AF type. LA reverse remodeling occurred in 81.7% (n = 30) of hybrid patients and 67.8% (n = 19) of no-hybrid patients at latest control (p = 0.02). Left atrial emptying fraction increased in both groups (50 ± 14%, p <0.001and 52 ± 12%, p = 0.004 in hybrid and no-hybrid, respectively) without differences between groups (p = 0.6). Conclusions: The hybrid procedure yielded excellent results in long-standing persistent AF. Our findings need to be confirmed by further larger studies.

Original languageEnglish
Pages (from-to)1469-1475
Number of pages7
JournalInternational Journal of Cardiology
Volume167
Issue number4
DOIs
Publication statusPublished - Aug 20 2013

Keywords

  • Ablation
  • Atrial fibrillation
  • Surgical ablation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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