Hybrid surgical and interventional ablation versus video-assisted thoracoscopic surgical ablation for persistent atrial fibrillation: A case control study
10.7507/1007-4848.201804059
- VernacularTitle:胸腔镜下外科消融和复合技术治疗持续性心房颤动的病例对照研究
- Author:
LI Haojie
1
;
ZHENG Zhe
1
;
MENG Ying
1
;
GAO Ge
1
;
WANG Xiaoqi
1
;
FAN Hongguang
1
;
LI Linlin
1
;
ZHONG Zhaoji
1
Author Information
1. Department of Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Disease, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100037, P.R.China
- Publication Type:Journal Article
- Keywords:
Persistent atrial fibrillation;
thoracoscope;
hybrid ablation;
efficacy
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2018;25(10):844-848
- CountryChina
- Language:Chinese
-
Abstract:
Objective To verify whether hybrid surgical and interventional ablation(HA) for the treatment of persistent atrial fibrillation (AF) is superior to video-assisted thoracoscopic surgical radiofrequency ablation (VATS-RA). Methods From September 2010 to December 2017, 79 consecutive patients with persistent AF underwent VATS-RA or HA in Fuwai Hospital. VATS-RA was performed in sixty patients (a stand-alone surgical group, 48 males and 12 females, at average age of 56.0±7.6 years, and HA was performed in nineteen patients (a hybrid group, 14 males and 5 females, at average age of 58.0±7.3 years). Follow-up was completed at 3 months, 6 months, 1 year and annually thereafter. Postoperative sinus rhythm was defined as sinus rhythm recorded in 24-hour or 7-day Holter during follow-up, without exhibited rapid atrial tachyarrhythmia≥30 s including AF, atrial flutter, or atrial tachycardia. Results Seventy-eight patients (98.7%) completed the follow-up. Although the preoperative left atrial diameter (49.1±5.3 mm) in the hybrid group was significantly greater than that in the stand-alone surgical group (41.7±6.2 mm, P<0.001). Overall sinus rhythm maintenance rate in the hybrid group was significantly greater than that in the stand-alone surgical group (94.7% versus 64.4%, P=0.011). And sinus rhythm maintenance rate free from anti-arrhythmic drugs (AADs) and catheter ablation in the hybrid group was significantly greater than that in the stand-alone surgical group (84.2% versus 50.8%, P=0.010). Conclusion HA is superior to VATS-RA in the treatment of persistent AF, but a larger sample size is needed for further validation in prospective randomized studies.
