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Updated: May 14, 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

Convergent Hybrid Ablation and Concomitant Left Atrial Appendage Exclusion for Stroke Prevention and Rhythm Control

Yonas R Toma1, Sune Damgaard1, Christian L Carranza1

  • 1Department of Cardiothoracic Surgery, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark.

Journal of Clinical Medicine
|May 13, 2026
PubMed

Insights

This study shows combining left atrial appendage exclusion with Convergent Hybrid Ablation is safe and effective for managing persistent atrial fibrillation (AF) and preventing strokes in complex patients. Further research is needed for long-term stroke risk reduction confirmation.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Persistent and long-standing persistent atrial fibrillation (AF) pose significant clinical challenges, particularly regarding stroke risk.
  • The left atrial appendage (LAA) is a primary source of thromboembolism in AF patients.
  • Current therapeutic strategies require optimization for rhythm control and stroke prevention in refractory cases.

Purpose of the Study:

  • To evaluate the safety and efficacy of combining Left Atrial Appendage (LAA) exclusion with Convergent Hybrid Ablation.
  • To assess stroke prevention and rhythm control outcomes in patients with refractory persistent or long-standing persistent AF.
  • To determine the feasibility of a multi-step approach for complex AF management.

Main Methods:

  • A single-center observational cohort study involving 28 patients with symptomatic persistent or long-standing persistent AF.
  • The hybrid procedure included epicardial ablation, thoracoscopic LAA exclusion (AtriClip), and endocardial catheter ablation.
  • Safety and efficacy were assessed at 3 and 12 months post-procedure.

Main Results:

  • Successful LAA exclusion was achieved in 96.4% of patients with acceptable peri-operative safety (zero strokes/deaths).
  • At 12 months, freedom from AF was 75.0% and freedom from any atrial arrhythmia off anti-arrhythmic drugs was 50.0%.
  • No thromboembolic events or major adverse events were observed at 12-month follow-up; 32.1% required additional ablation.

Conclusions:

  • Concomitant LAA exclusion during Convergent Hybrid Ablation is safe and effective for rhythm control in complex AF patients.
  • The procedure demonstrated a high success rate in maintaining sinus rhythm and preventing thromboembolic events at 12 months.
  • Larger studies are needed to confirm long-term stroke risk reduction; the hybrid procedure may be part of a multi-step strategy.

Keywords:
atrial fibrillationconvergent procedurehybrid ablationleft atrial appendage exclusionrhythm controlstroke prevention

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