The Lead Episode 31: Efficacy and Safety of Hybrid Epicardial and Endocardial Ablation versus Endocardial Ablation in Patients with Persistent and Longstanding Persistent Atrial Fibrillation-The Lancet

The Lancet

Pdf Summary

A randomized controlled trial compared the efficacy and safety of hybrid epicardial-endocardial ablation versus endocardial ablation in patients with persistent and longstanding persistent atrial fibrillation (AF). The study enrolled 154 patients, with 102 receiving hybrid ablation and 52 receiving endocardial ablation. The primary effectiveness endpoint was freedom from AF/atrial flutter/atrial tachycardia through 12 months without the use of class I/III anti-arrhythmic drugs, and the results showed that hybrid ablation had a significantly higher effectiveness rate compared to endocardial ablation (71.6% vs 39.2%). The study also found that the hybrid ablation approach did not significantly increase the risk of major complications compared to endocardial ablation. The authors suggest that hybrid ablation, which combines both epicardial and endocardial ablation, may be a more effective treatment option for patients with persistent and longstanding persistent AF. However, further research is needed to confirm these findings and determine the long-term outcomes of the hybrid ablation approach.

Keywords

randomized controlled trial

hybrid epicardial-endocardial ablation

endocardial ablation

persistent atrial fibrillation

longstanding persistent atrial fibrillation

efficacy

safety

effectiveness endpoint

anti-arrhythmic drugs

major complications