Hybrid minimally invasive surgical and transcatheter ablation for long-standing persistent atrial fibrillation
10.3760/cma.j.issn.1001-4497.2018.12.005
- VernacularTitle:微创外科-导管杂交消融术在长程持续性房颤治疗中的应用及疗效
- Author:
Ju MEI
1
;
Zhaolei JIANG
;
Xingpeng LIU
;
Chen TAN
;
Nan MA
;
Hao LIU
;
Min TANG
;
Sai'e SHEN
;
Fangbao DING
;
Jiaquan ZHU
Author Information
1. 200092,上海交通大学医学院附属新华医院心胸外科
- Keywords:
Long-standing persistent atrial fibrillation;
Hybrid surgery;
Minimally invasive surgical ablation;
Transcatheter ablation
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2018;34(12):724-728
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the application and effectiveness of one-staged or two-staged hybrid minimally invasive surgical and transcatheter ablation for long-standing persistent atrial fibrillation(LSPAF).Methods From Jun 2015 to Dec 2017,a cohort of 56 patients[18 female,mean age of(59.1 ±6.9) years] with long-standing persistent atrial fibrillation underwent one-staged(30 cases) or two-staged(26 cases) hybrid minimally invasive surgical and transcatheter ablation.Mean AF duration was(5.9 ± 3.0) years.Mean left atrial diameter was(45.4 ± 4.2) mm.Mean CHA2DS2-VASc score was 2.3 ± 1.2.Fourteen cases had a history of prior catheter ablation.All patients underwent continuous 24-hour or 48-hour holter monitoring at 3 months,6 months,1 year and yearly thereafter.Results All patients successfully underwent one-staged or two-staged hybrid minimally invasive surgical and transcatheter ablation.During ablation,LSPAF was terminated in 80.0％ (24/30) with one-staged hybrid ablation and 84.6％ (22/26) with two-staged hybrid ablation.At a mean follow-up of(20.3 ± 8.2) months,89.3％ (50/56) patients maintained sinus rhythm.Among them,86.7％ (26/30) patients with one-staged hybrid ablation maintained sinus rhythm,and 92.3％ (50/56) patients with two-staged hybrid ablation maintained sinus rhythm.Six patients with recurrent AF continued to receive warfarin and amiodarone drug therapy.No death or cerebrovascular events occurred.No patient required permanent pacemaker implantation.Conclusion One-staged or two-staged hybrid minimally invasive surgical and transcatheter ablation could be safely and effectively applied to the treatment of LSPAF.The early and midterm outcomes were satisfactory.
