Journal article
The convergent procedure: a hybrid approach for long lasting persistent atrial fibrillation ablation
Journal of cardiovascular surgery, Vol.61(3), pp.369-375
06/01/2020
DOI: 10.23736/S0021-9509.19.10701-X
PMID: 31603290
Abstract
BACKGROUND: Atrial fibrillation (AF) is associated with increased risk of stroke, heart failure and all-cause mortality. The Cox-Maze procedure is the most effective approach to ablate persistent AF but presents a significant morbidity and mortality. Additionally, the classical endocardial ablation approach has limited efficacy to treat long lasting persistent AF. We described a new, minimally invasive hybrid approach, combining an endocardial and epicardial ablation named convergent procedure to treat long lasting persistent AF patients.
METHODS: We studied 55 consecutive patients with long lasting persistent AF who underwent the convergent procedure in 2 French centers between 2010 and 2015. Alltients had at least one previous failed endocardial ablation and were highly symptomatic. Patients with a history of thoracic surgery were excluded. A 24 hour-Holter ECG was performed systematically at 3, 6 and 12 months after the convergent procedure. All patients reached 1-year follow-up.
RESULTS: No death, stroke, phrenic nerve palsy or tamponade occurred immediately after the procedure. Post-surgery average length of stay was 8 +/- 4 days. Later, 3 patients (5%) developed diaphragmatic hernia resulting in a modified surgery technique. At 12 months, 76% of patients were in sinus rhythm after an average of 1.43 ablation procedure. Finally, 91% of patients were maintained on antiarrhythmic drugs.
CONCLUSIONS: Thoracoscopic hybrid epicardial-endocardial ablation technique proved to be effective and safe to treat long lasting persistent AF patients with previous failed endocardial AF ablation.
Details
- Title: Subtitle
- The convergent procedure: a hybrid approach for long lasting persistent atrial fibrillation ablation
- Creators
- Konstantinos Zannis - Institute Mutualiste MontsourisWissam Alam - Assistance Publique – Hôpitaux de ParisFrederic A. Sebag - Institute Mutualiste MontsourisThierry Folliguet - Univ Lorraine, Ctr Hosp Reg Univ Nancy CHRU, Vandoeuvre Les Nancy, FranceClement Bars - St Joseph Hosp, Intervent Rhythmol, Marseille, FranceMiche Fahed - Assistance Publique – Hôpitaux de ParisJulien Ternacle - Assistance Publique – Hôpitaux de ParisEric Bergoend - Assistance Publique – Hôpitaux de ParisDavid Hamon - Assistance Publique – Hôpitaux de ParisNicolas Lellouche - Assistance Publique – Hôpitaux de Paris
- Resource Type
- Journal article
- Publication Details
- Journal of cardiovascular surgery, Vol.61(3), pp.369-375
- Publisher
- Edizioni Minerva Medica
- DOI
- 10.23736/S0021-9509.19.10701-X
- PMID
- 31603290
- ISSN
- 0021-9509
- eISSN
- 1827-191X
- Number of pages
- 7
- Language
- English
- Date published
- 06/01/2020
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984691517502771
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