Updates on Hybrid Ablation in the Management of Atrial Fibrillation (non-ACE)-Updates on Hybrid Ablation in the Management of Atrial Fibrillation (non-ACE)

Video Transcription

Video Summary

The session on hybrid ablation and atrial fibrillation management at HRS 2025 in San Diego featured several expert speakers. Dr. Adol Carpio discussed hybrid ablation, emphasizing its potential in treating persistent atrial fibrillation by combining epicardial and endocardial techniques. Hybrid ablation offers better lesion durability and targets non-pulmonary vein triggers. Despite promising outcomes, the approach's evidence base remains limited, necessitating further research.<br /><br />Dr. Gorey discussed the convergent hybrid ablation, a two-stage strategy combining surgical and electrophysiological methods. Initial studies, including the CONVERGE trial, demonstrated improved success rates with hybrid ablation compared to traditional catheter methods, although logistical challenges and higher costs remain.<br /><br />Dr. Kessler provided a critical appraisal, highlighting the limitations of current research, such as high complication rates and the need for more comprehensive trials, particularly in long-standing persistent AF patients. The advent of pulse field ablation (PFA) could offer a less invasive and safer alternative, challenging the role of hybrid ablation.<br /><br />Dr. Wymer focused on complications associated with hybrid ablation, noting slightly elevated but acceptable rates given the complex patient cases typically involved. The collaboration between cardiac surgeons and electrophysiologists is crucial for hybrid procedures, but practical challenges like insurance approvals and synchronization of schedules exist.<br /><br />Overall, while hybrid ablation shows promise for complex AF cases, it requires rigorous trials to validate efficacy and safety compared to emerging technologies like PFA.

Keywords

hybrid ablation

atrial fibrillation

HRS 2025

epicardial techniques

endocardial techniques

CONVERGE trial

pulse field ablation

cardiac surgeons

electrophysiologists

AF management