Hôpital Rangueil, CHU Toulouse, Toulouse, France.
Hôpital Rangueil, CHU Toulouse, Toulouse, France.
Ann Cardiol Angeiol (Paris). 2020 Apr;69(2):86-92. doi: 10.1016/j.ancard.2020.03.008. Epub 2020 Mar 30.
Hybrid ablation for the treatment of atrial fibrillation is a single combined procedure consisting in a minimally thoracoscopic surgical ablation followed by a catheter ablation. This promising technique is recommended in persistent atrial fibrillation according to the current guidelines but is not routinely performed in France, mainly due to the absence of reimbursement by the French National Health Insurance.
The aim of this prospective and single-centre study was to analyse, for the first time in France, the feasibility, efficacy and complication rates of hybrid ablation in patients with persistent atrial fibrillation.
Hybrid ablation was performed in 15 consecutive patients (13 men, mean age 61±6 years) with persistent (7 patients) or long standing persistent (8 patients) atrial fibrillation.
Hybrid ablation was completed in 14/15 patients. Eleven patients returned in sinus rhythm during the procedure. Two patients (13%) had major per-procedural complications and 2 had minor complications. During an average follow-up of 25±6 months, 6 patients (40%) underwent a redo catheter ablation because of atrial tachycardia, mainly peri-mitral atrial flutter. At 1 year follow up, 14/15 patients were in sinus rhythm, including 11 free of antiarrhythmic drugs.
心房颤动的杂交消融是一种单一的联合手术,包括微创胸腔镜手术消融和导管消融。根据目前的指南,这种有前途的技术推荐用于持续性心房颤动,但在法国并未常规应用,主要是由于法国国家健康保险不报销。
本前瞻性单中心研究首次在法国分析了杂交消融治疗持续性心房颤动的可行性、疗效和并发症发生率。
15 例连续患者(13 例男性,平均年龄 61±6 岁)接受了持续性(7 例)或长程持续性(8 例)心房颤动的杂交消融。
14/15 例患者完成了杂交消融。11 例患者在手术过程中恢复窦性心律。2 例患者(13%)发生主要围手术期并发症,2 例患者发生轻微并发症。平均随访 25±6 个月后,6 例患者(40%)因房性心动过速(主要为二尖瓣环旁房性扑动)行再次导管消融。1 年随访时,15 例患者中的 14 例恢复窦性心律,其中 11 例未服用抗心律失常药物。