Two-staged hybrid ablation versus thoracoscopic epicardial ablation for long-standing persistent atrial fibrillation: Mid-long term result of a randomized controlled trial
- VernacularTitle:分站式杂交消融术与微创迷宫消融术治疗长程持续性心房颤动随机对照研究的中长期随访结果
- Author:
Yuyuan ZHANG
1
,
2
,
3
;
Rong ZENG
1
,
2
,
3
;
Jian LIU
4
,
5
;
Peijian WEI
4
,
5
;
Zhao CHEN
4
,
5
;
Fangzhou LIU
4
,
5
;
Xianzhang ZHAN
4
,
5
;
Yumei XUE
4
,
5
;
Huiming GUO
4
,
5
Author Information
1. Department of Cardiovascular Surgery, Guangdong General Hospital&rsquo
2. s Nanhai Hospital, The Second People&rsquo
3. s Hospital of Nanhai District, Foshan, 528251, Guangdong, P.R.China
4. Atrial Fibrillation Center, Guangdong Provincial People&rsquo
5. s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial
- Publication Type:Journal Article
- Keywords:
Two-staged;
hybrid ablation;
thoracoscopic epicardial ablation;
catheter ablation;
long-standing persistent atrial fibrillation
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2021;28(02):174-181
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of hybrid ablation through compared with thoracoscopic epicardial ablation. Methods In this study, 108 patients with all long-standing persistent atrial fibrillation (LSPAF) received thoracoscopic epicardial ablation (TEA) after enrollment. There were 82 males and 26 females at age of 56.5±9.4 years. After blanking-period, patients off antiarrhythmic therapy with sinus rhythm were divided into a hybrid ablation (HA) group (50 patients) and a TEA group (58 patients). Only patients in the HA group received catheter ablation after randomization subsequently. In at least two-year observation period, cardiovascular risk factors were observed in all groups’ patients. Results The mean follow-up duration was 17.3-41.8 (26.9±6.1) months and there was no significant difference between two groups [8.2-40.6 (27.5±5.7) months in the HA group and 17.3-41.8 (26.4±6.7) months in the TEA group]. The off antiarrhythmic agents (AADs) sinus rhythm rate was significantly higher in the HA group than that in the TEA group at the time of postoperative 6, 12, 24 and 36 months ［96.0%, 90.0%, 83.7%, 83.7% versus 79.3%, 75.9%, 67.3%, 63.1%, HR=0.415 (95%CI 0.206-0.923)]. Conclusion We can conclude that the efficacy of two-staged hybrid ablation for LSPAF is superior to thoracoscopic epicardial ablation alone. Patients can obtain benefit from a supplemental radiofrequency catheter ablation after blanking-period of surgical ablation, instead of those without a supplemental ablation.
