title: Hybrid thoracoscopic and transvenous catheter ablation of atrial fibrillation.
abstract: 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.
authors.affiliation: Cardiology and Cardiothoracic Department, Maastricht University Hospital, Maastricht, Netherlands.
authors.forename: Sandro
authors.initials: S
authors.lastname: Gelsomino
authors.forename: Henrica N A M
authors.initials: HN
authors.lastname: Van Breugel
authors.forename: Laurant
authors.initials: L
authors.lastname: Pison
authors.forename: Orlando
authors.initials: O
authors.lastname: Parise
authors.forename: Hanry J G M
authors.initials: HJ
authors.lastname: Crijns
authors.forename: Francis
authors.initials: F
authors.lastname: Wellens
authors.forename: Jos G
authors.initials: JG
authors.lastname: Maessen
authors.forename: Mark
authors.initials: M
authors.lastname: La Meir
mesh_terms: D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D013906:Thoracoscopy / Q000379:methods*
keywords: Ablation; Atrial fibrillation; Surgery