Initial experience with total thoracoscopic ablation

Area of Science:

• Cardiology
• Cardiac Electrophysiology
• Minimally Invasive Surgery

Background:

• Current atrial fibrillation (AF) ablation methods have limitations.
• A hybrid surgical-electrophysiological (EP) approach was proposed to improve outcomes.
• This study evaluates a novel hybrid strategy for AF management.

Purpose of the Study:

• To assess the efficacy and safety of a hybrid approach combining total thoracoscopic ablation (TTA) and transvenous catheter EP ablation.
• To evaluate the outcomes of this hybrid strategy in patients with AF, particularly those at high risk of recurrence.

Main Methods:

• Ten consecutive patients with AF underwent TTA followed by transvenous catheter EP ablation (including residual gap and cavotricuspid isthmus [CTI] ablation).
• Postoperative Holter monitoring was performed at 6 months.
• Electrophysiological (EP) study was conducted in 8 patients to assess ablation success.

Main Results:

• The hybrid procedure was successful in all 10 patients with no in-hospital mortality.
• Successful antral ablation of pulmonary veins was achieved in 7 of 8 patients who underwent EP study.
• No AF recurrence was observed during a median follow-up of 7.63 months, with all patients maintaining sinus rhythm.

Conclusions:

• The hybrid approach of TTA followed by transvenous catheter EP ablation yields excellent outcomes for AF patients.
• This hybrid strategy is a promising option for patients at high risk of AF recurrence.
• Consideration of this hybrid approach is recommended for selected AF patient populations.