Gelsomino Sandro, Van Breugel Henrica N A M, Pison Laurant, Parise Orlando, Crijns Hanry J G M, Wellens Francis, Maessen Jos G, La Meir Mark
Cardiology and Cardiothoracic Department, Maastricht University Hospital, Maastricht, Netherlands.
Eur J Cardiothorac Surg. 2014 Mar;45(3):401-7. doi: 10.1093/ejcts/ezt385. Epub 2013 Jul 31.
The hybrid approach combines an epicardial ablation with a percutaneous endocardial ablation in a single-step or sequential procedure. This study provides an overview of the hybrid procedure for the treatment of stand-alone atrial fibrillation (AF). Papers selected for this review were identified on PubMed and the final selection included nine studies. The total number of patients was 335 (range 15-101). Mean age ranged from 55.2 to 62.9 years. The hybrid approach achieved satisfactory results, with AF-antiarrhythmic drug-free success rates higher than those in isolated procedures. In particular, the bilateral approach with a bipolar device showed a high success rate independently of the AF type and seems to be the better choice for the hybrid procedure. Despite good preliminary results, large, multicentre trials of hybrid AF ablation that target a population of patients with long-standing persistent disease are necessary to establish whether this approach may represent, in the future, a gold-standard treatment for AF.
混合方法在单步或序贯手术中将心外膜消融与经皮心内膜消融相结合。本研究概述了用于治疗孤立性心房颤动（AF）的混合手术。通过PubMed确定了本综述所选的论文，最终入选的有9项研究。患者总数为335例（范围15 - 101例）。平均年龄在55.2至62.9岁之间。混合方法取得了令人满意的结果，无抗心律失常药物的房颤成功率高于单独手术。特别是，采用双极设备的双侧方法显示出较高的成功率，与房颤类型无关，似乎是混合手术的更佳选择。尽管取得了良好的初步结果，但仍需要针对长期持续性疾病患者群体进行大规模、多中心的混合房颤消融试验，以确定这种方法未来是否可能成为房颤的金标准治疗方法。
