We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Convergent ablation for persistent atrial fibrillation: Single center experience.
- Authors
Gulkarov, Iosif; Wong, Brian; Kowalski, Marcin; Worku, Berhane; Afzal, Ashwad; Ivanov, Alexander; Ramasubbu, Kumudha; Reddy, Bharath
- Abstract
<bold>Background: </bold>Endocardial catheter ablation has been shown to be effective in patients with paroxysmal atrial fibrillation (AF), and significantly less effective in patients with persistent AF (PAF). Lately, there is a trend toward a hybrid approach in the treatment of PAF that may be a more durable treatment for patients with PAF. In this manuscript we report our experience with the convergent ablation procedure in a PAF cohort.<bold>Methods: </bold>This is a single center retrospective analysis of 31 patients with PAF who underwent the convergent procedure. All patients underwent surgical epicardial ablation of the posterior left atrial through a subxiphoid approach, followed by radiofrequency endocardial ablations on the same day. Patients were followed at 6 months intervals with static electrocardiograms or implanted devices.<bold>Results: </bold>Sinus rhythm was achieved intraoperatively in all patients. Recurrence was defined according to Hearlt Rhythm Society definitions. At a median follow up of 17.7 months (IQR 11-24), the recurrence of atrial tachyarrhythmia (AF and atrial flutter) by Kaplan-Meier event free survival analysis occurred in 9 (29%) patients at 1-year follow up and 15 (48%) patients at 2-year follow up with or without the use of antiarrhythmic drugs. Recurrence of AF alone occurred in 4 (13%) patients at 1-year follow up and 9 (29%) patients at 2-year follow up patients. Complication rate in perioperative period was 12.9%.<bold>Conclusion: </bold>Our experience showed the hybrid procedure is a relatively safe and effective option for patients with PAF. Further studies are needed to better determine its long-term outcomes.
- Subjects
ATRIAL fibrillation; ATRIAL flutter; BODY surface mapping; ARTIFICIAL implants; CATHETER ablation; SURVIVAL analysis (Biometry); ELECTROCARDIOGRAPHY; ENDOCARDIUM; HEART conduction system; LONGITUDINAL method; PROGNOSIS; TIME; DISEASE relapse; TREATMENT effectiveness; RETROSPECTIVE studies
- Publication
Journal of Cardiac Surgery, 2019, Vol 34, Issue 10, p1037
- ISSN
0886-0440
- Publication type
journal article
- DOI
10.1111/jocs.14204