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Related Concept Videos

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Cardiac Catheterization III: Left Heart Catheterization

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Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
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Related Experiment Video

Updated: May 9, 2026

Robotic Ablation of Atrial Fibrillation
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Hybrid Atrial Fibrillation Ablation: A Decade-Long Single-Center Experience.

Giuseppe Nasso1,2, Walter Vignaroli3, Cosimo Domenico Dicandia1

  • 1Department of Cardiac Surgery, Anthea Hospital and Santa Maria Hospital GVM Care & Research, 70131 Bari, Italy.

Reviews in Cardiovascular Medicine
|January 12, 2026
PubMed
Summary

Hybrid ablation offers durable rhythm control for persistent atrial fibrillation (AF). Immediate procedures and Bachmann's bundle (BB) ablation improve outcomes and reduce hospital stays.

Keywords:
Bachmann's bundleablationatrial fibrillationcardiac surgery

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Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Electrophysiology

Background:

  • Long-standing persistent atrial fibrillation (AF) presents a significant health challenge, often resisting conventional treatments.
  • Hybrid ablation, combining surgical and catheter techniques, offers a solution for complex AF cases.
  • Limited data exist on the long-term effectiveness of immediate versus staged hybrid ablation strategies and the role of Bachmann's bundle (BB) ablation.

Purpose of the Study:

  • To compare the long-term effectiveness of immediate versus staged hybrid ablation for persistent AF.
  • To evaluate the impact of adjunctive Bachmann's bundle (BB) ablation on outcomes.
  • To assess safety, procedural complications, and hospitalization duration.

Main Methods:

  • A retrospective cohort study of 60 patients with long-standing persistent AF undergoing hybrid ablation (2008-2020).
  • Patients received epicardial ablation followed by endocardial catheter ablation either immediately or staged (≥4 weeks later).
  • A subset underwent adjunctive BB ablation; primary outcome was freedom from AF recurrence.

Main Results:

  • At 106 months follow-up, 90.0% in the immediate group and 62.5% in the staged group maintained sinus rhythm (p=0.034).
  • BB ablation was linked to improved rhythm control (90% vs. 70%; p=0.04).
  • Immediate procedures resulted in shorter hospital stays (5.6 vs. 8.8 days; p<0.001) with no major adverse events.

Conclusions:

  • Hybrid ablation demonstrates durable rhythm control and safety for persistent AF.
  • Bachmann's bundle (BB) ablation enhances procedural success and should be considered.
  • Immediate hybrid ablation may be beneficial for selected patients, potentially reducing healthcare utilization.