Marini Massimiliano, Pannone Luigi, Della Rocca Domenico G, Branzoli Stefano, Bisignani Antonio, Mouram Sahar, Del Monte Alvise, Monaco Cinzia, Gauthey Anaïs, Eltsov Ivan, Overeinder Ingrid, Bala Gezim, Almorad Alexandre, Ströker Erwin, Sieira Juan, Brugada Pedro, La Meir Mark, Chierchia Gian-Battista, De Asmundis Carlo, Guarracini Fabrizio
Department of Cardiology, S. Chiara Hospital, 38122 Trento, Italy.
Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, 1050 Brussels, Belgium.
J Cardiovasc Dev Dis. 2022 Sep 8;9(9):302. doi: 10.3390/jcdd9090302.
Electrical isolation of pulmonary veins (PVI) is the cornerstone of invasive treatment of atrial fibrillation (AF). However, arrhythmia-free survival of a PVI only approach is suboptimal in patients with persistent and long-term persistent AF. Hybrid AF ablation has been developed with the aim of combining the advantages of a thoracoscopic surgical ablation (direct visualization of anatomical structures to be spared and the possibility to perform epicardial lesions) and endocardial ablation (possibility to check line block, confirm PVI, and possibility to perform cavotricuspid isthmus ablation). Patient selection is of utmost importance. In persistent and long-term persistent AF, hybrid AF ablation demonstrated promising results in terms of AF free survival. It has been associated with a relatively low complication rate if performed in centers with expertise in hybrid procedures and experience with both surgical and endocardial ablation. Different techniques have been described, with different approaches and lesion sets. The aim of this review is to provide a state-of-the-art overview of hybrid AF ablation.
肺静脉电隔离（PVI）是心房颤动（AF）侵入性治疗的基石。然而，对于持续性和长期持续性房颤患者，仅采用PVI方法实现无心律失常生存的效果并不理想。混合式房颤消融术应运而生，其目的是结合胸腔镜手术消融（可直接观察需保留的解剖结构并进行心外膜损伤）和心内膜消融（可检查线路阻滞、确认肺静脉隔离以及进行腔静脉-三尖瓣峡部消融）的优点。患者选择至关重要。在持续性和长期持续性房颤中，混合式房颤消融术在无房颤生存方面显示出了有前景的结果。如果在具备混合手术专业知识以及外科和心内膜消融经验的中心进行，其并发症发生率相对较低。已经描述了不同的技术，包括不同的方法和消融灶。本综述的目的是提供混合式房颤消融术的最新概述。
