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Updated: Feb 10, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

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Comparative Effectiveness of Hybrid Ablation Versus Endocardial Catheter Ablation Alone in Patients With Persistent

David C Kress1, Lynn Erickson1, Indrajit Choudhuri1

  • 1Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, Wisconsin.

JACC. Clinical Electrophysiology
|May 16, 2018
PubMed

Insights

Hybrid ablation significantly reduces atrial fibrillation recurrence and repeat procedures compared to endocardial ablation alone in persistent AF patients. Further trials are needed to confirm these findings.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Persistent atrial fibrillation (AF) management remains challenging, with variable outcomes after endocardial catheter ablation.
  • Hybrid epicardial-endocardial ablation has emerged as a promising alternative for refractory cases.

Purpose of the Study:

  • To compare the effectiveness of hybrid ablation versus endocardial ablation alone in patients with persistent and long-standing persistent AF.
  • To evaluate recurrence rates and need for repeat procedures in both ablation strategies.

Main Methods:

  • A study involving 133 patients with persistent AF, divided into endocardial ablation alone (n=69) and hybrid epicardial-endocardial ablation (n=64) groups.
  • Patients were followed for a median of 16 months, with recurrence defined as any arrhythmia post-blanking period.

Main Results:

  • The hybrid group demonstrated significantly lower recurrence rates (37% vs. 58%) and repeat ablations (9% vs. 26%) compared to the endocardial group.
  • AF-free survival was higher in the hybrid group (72% vs. 51%).
  • Despite longer AF duration and more prior ablations in the hybrid group, outcomes were superior.

Conclusions:

  • Hybrid ablation is associated with reduced AF recurrence and fewer re-do ablations in persistent AF patients.
  • These findings suggest hybrid ablation as a more effective strategy for selected patients.
  • Large-scale randomized trials are warranted to validate these promising results.
Abstract

Keywords:
ablationatrial fibrillationhybridoutcomespersistent

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