Surgical and hybrid atrial fibrillation ablation procedures.
OBJECTIVE
The purpose of this EP Wire is to survey clinical practice in this rapidly evolving field as the variety of surgical techniques and the heterogeneity of treated patients make the comparison of results and outcomes challenging.


RESULTS
Twenty-four European centres, all members of the EHRA EP research network, responded to this survey and completed the questions. Of the participating centres, 11 (46%) performed (irrespective of the technique) stand-alone surgical atrial fibrillation (AF) ablation in 2011. Seven hospitals (64%) performed totally thoracoscopic AF ablation procedures off-pump (in 20-100% of their cases). The most commonly used lesion set was only pulmonary vein isolation in five hospitals (46%). Eight centres (73%) performed validation of the surgical lesion set at the time of intervention. The most important indication for performing stand-alone, totally thoracoscopic surgical AF ablation in seven participating hospitals was failed catheter ablation. According to their definition of success, participating centres reported their success rate to be 10-100% for paroxysmal AF and 0-95% for (longstanding) persistent AF. The most frequently encountered complications during stand-alone, surgical AF ablation were pneumothorax and haemothorax in up to 10% of the cases.


CONCLUSIONS
This EP Wire survey shows a wide variation not only in indications for stand-alone, surgical AF ablation, but also in surgical techniques, lesion sets, follow-up, and outcome.
Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute, Maastricht, PO Box 5800, The Netherlands. l.pison@mumc.nl
Laurent
L
Pison
Nikolaos
N
Dagres
Thorsten
T
Lewalter
Alessandro
A
Proclemer
Germanas
G
Marinskis
Carina
C
Blomström-Lundqvist
D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000601:surgery*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D015897:Comorbidity; D005060:Europe / Q000453:epidemiology; D019538:Health Care Surveys; D006491:Hemothorax / Q000453:epidemiology*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000706:statistics & numerical data; D011030:Pneumothorax / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D013906:Thoracoscopy / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014600:Utilization Review