Middle-term results of hybrid atrial fibrillation ablation
using AtriCure system

J 2017

Middle-term results of hybrid atrial fibrillation ablation using AtriCure system

BULAVA, Alan, Ales MOKRACEK, Martin EISENBERGER, Vojtech KURFIRST, Ladislav DUŠEK et. al.

Základní údaje

Originální název

Middle-term results of hybrid atrial fibrillation ablation using AtriCure system

Autoři

BULAVA, Alan (203 Česká republika), Ales MOKRACEK (203 Česká republika), Martin EISENBERGER (203 Česká republika), Vojtech KURFIRST (203 Česká republika) a Ladislav DUŠEK (203 Česká republika, garant, domácí)

Vydání

Cor et Vasa, AMSTERDAM, ELSEVIER SCIENCE BV, 2017, 0010-8650

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Nizozemské království

Utajení

není předmětem státního či obchodního tajemství

Kód RIV

RIV/00216224:14110/17:00098097

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1016/j.crvasa.2017.05.004

UT WoS

000410033600011

Klíčová slova anglicky

RF catheter ablation; Atrial fibrillation; Hybrid approach; Epicardial ablation

Štítky

EL OK

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 22. 3. 2018 16:34, Soňa Böhmová

Anotace

V originále

Introduction: Long-term results of catheter ablation (CA) for persistent and long-standing persistent atrial fibrillation (AF) are disappointing. The hybrid approach is currently one of options for overcoming the limitations of CA. Aim: To evaluate the safety and medium-term efficacy of the hybrid approach in patients with persistent and long-standing persistent AF. Methods: All patients underwent epicardial thoracoscopic radiofrequency (RF) pulmonary vein (PV) isolation using the AtriCure clamp followed by left atrial (LA) linear lesions (using a linear pen), Marshall ligament disruption, and LA appendage exclusion using an Atriclip. All patients underwent an electrophysiological study (EPS) and RF CA 2-3 months after the initial surgery to eliminate recurrent conductions from/to the PVs or across the linear lesions, and to eliminate all spontaneous and inducible atrial arrhythmias. 7-Day ECG Holter monitoring was performed every 3 months during the first year and every 6 months afterwards to evaluate possible recurrent arrhythmias. Results: Seventy patients (49 male, median 63.5 years) took part in the study. EPS was performed 87 days (median) after the thoracoscopic surgery. Seventy-six percent of patients were in normal sinus rhythm (SR) at the start of the EPS, 7% had typical atrial flutter, 11% had atrial tachycardia, and 6% were in AF. After completion of the hybrid approach, all PVs were isolated, while a complete conduction block across the linear lines was achieved in 88.6% of patients. Twelve months after the procedure, 77.1% of patients had a stable SR without any anti-arrhythmic medication or re-ablation. If we included those on anti-arrhythmic drugs and re-ablation procedures, SR was achieved in 96.5% of patients during follow-up (936 +/- 432 days). Conclusion: The sequential hybrid approach is probably the most effective and relatively safe invasive treatment for persistent and long-term persistent AF with very low medium- to long-term recurrences. Introduction of the hybrid approach to clinical practice requires extensive cooperation between cardiologic and cardiothoracic teams. (C) 2017 The Czech Society of Cardiology. Published by Elsevier Sp. zo.o. All rights reserved.

Citovat

BULAVA, Alan, Ales MOKRACEK, Martin EISENBERGER, Vojtech KURFIRST a Ladislav DUŠEK. Middle-term results of hybrid atrial fibrillation ablation using AtriCure system. Cor et Vasa. AMSTERDAM: ELSEVIER SCIENCE BV, 2017, roč. 59, č. 4, s. "E345"-"E352", 8 s. ISSN 0010-8650. Dostupné z: https://dx.doi.org/10.1016/j.crvasa.2017.05.004.

@article{1394053,
   author = {Bulava, Alan and Mokracek, Ales and Eisenberger, Martin and Kurfirst, Vojtech and Dušek, Ladislav},
   article_location = {AMSTERDAM},
   article_number = {4},
   doi = {http://dx.doi.org/10.1016/j.crvasa.2017.05.004},
   keywords = {RF catheter ablation; Atrial fibrillation; Hybrid approach; Epicardial ablation},
   language = {eng},
   issn = {0010-8650},
   journal = {Cor et Vasa},
   title = {Middle-term results of hybrid atrial fibrillation ablation using AtriCure system},
   volume = {59},
   year = {2017}
}

TY  - JOUR
ID  - 1394053
AU  - Bulava, Alan - Mokracek, Ales - Eisenberger, Martin - Kurfirst, Vojtech - Dušek, Ladislav
PY  - 2017
TI  - Middle-term results of hybrid atrial fibrillation ablation using AtriCure system
JF  - Cor et Vasa
VL  - 59
IS  - 4
SP  - "E345"-"E352"
EP  - "E345"-"E352"
PB  - ELSEVIER SCIENCE BV
SN  - 00108650
KW  - RF catheter ablation
KW  - Atrial fibrillation
KW  - Hybrid approach
KW  - Epicardial ablation
N2  - Introduction: Long-term results of catheter ablation (CA) for persistent and long-standing persistent atrial fibrillation (AF) are disappointing. The hybrid approach is currently one of options for overcoming the limitations of CA. Aim: To evaluate the safety and medium-term efficacy of the hybrid approach in patients with persistent and long-standing persistent AF. Methods: All patients underwent epicardial thoracoscopic radiofrequency (RF) pulmonary vein (PV) isolation using the AtriCure clamp followed by left atrial (LA) linear lesions (using a linear pen), Marshall ligament disruption, and LA appendage exclusion using an Atriclip. All patients underwent an electrophysiological study (EPS) and RF CA 2-3 months after the initial surgery to eliminate recurrent conductions from/to the PVs or across the linear lesions, and to eliminate all spontaneous and inducible atrial arrhythmias. 7-Day ECG Holter monitoring was performed every 3 months during the first year and every 6 months afterwards to evaluate possible recurrent arrhythmias. Results: Seventy patients (49 male, median 63.5 years) took part in the study. EPS was performed 87 days (median) after the thoracoscopic surgery. Seventy-six percent of patients were in normal sinus rhythm (SR) at the start of the EPS, 7% had typical atrial flutter, 11% had atrial tachycardia, and 6% were in AF. After completion of the hybrid approach, all PVs were isolated, while a complete conduction block across the linear lines was achieved in 88.6% of patients. Twelve months after the procedure, 77.1% of patients had a stable SR without any anti-arrhythmic medication or re-ablation. If we included those on anti-arrhythmic drugs and re-ablation procedures, SR was achieved in 96.5% of patients during follow-up (936 +/- 432 days). Conclusion: The sequential hybrid approach is probably the most effective and relatively safe invasive treatment for persistent and long-term persistent AF with very low medium- to long-term recurrences. Introduction of the hybrid approach to clinical practice requires extensive cooperation between cardiologic and cardiothoracic teams. (C) 2017 The Czech Society of Cardiology. Published by Elsevier Sp. zo.o. All rights reserved.
ER  -

BULAVA, Alan, Ales MOKRACEK, Martin EISENBERGER, Vojtech KURFIRST a Ladislav DUŠEK. Middle-term results of hybrid atrial fibrillation ablation using AtriCure system. \textit{Cor et Vasa}. AMSTERDAM: ELSEVIER SCIENCE BV, 2017, roč.~59, č.~4, s.~''E345''-''E352'', 8 s. ISSN~0010-8650. Dostupné z: https://dx.doi.org/10.1016/j.crvasa.2017.05.004.

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