58-05: Simultaneous thoracoscopic hybrid AF ablation: a 2-year follow up

Purpose: The purpose of this study was to analysis the efficacy and complication rates of the simultaneous hybrid procedure in a series of patients with persistent and long-standing persistent atrial fibrillation (AF) in a 2 year follow-up period. Methods: Sixty-one consecutive patients (54 males, 60 ± 8 years) having undergone isolation of pulmonary veins (PV) and posterior wall of left atrium (LA) by the means of hybrid thoracoscopic ablation for symptomatic persistent (n = 20, 33%) and long-standing persistent AF (n = 41, 67%) were analysed. Exclusion criteria were: paroxysmal AF, presence of intracavitary thrombus, uncontrolled heart failure, presence of severe coronary artery disease, moderate or severe valvular disease. Summary: At a mean follow up of 25.7 ± 14.1 months (median 24; range 8-58), the success rate without antiarrhythmic therapy was achieved in 67.2% of patients. Procedure-related complication were observed in 13 patients (21.3%) including 2 LA perforations (3.3%) requiring, respectively, conversion to sternotomy and small left-sided thoracotomy. The success rate did not significantly differ between persistent and long-standing persistent AF (respectively, 30.0% vs 34.1%; p = 0.5); Patients with AF relapse during the blanking period were 4.60 times more likely to have AF recurrence after 3 months from the ablation procedure. Conclusion: The hybrid procedure yields promising results in the setting of both persistent and long-standing persistent AF after 2 years follow up, at the expense of a non-negligible rate of adverse events. Our findings need to be confirmed by further larger and prospective studies.