Precis Future Med.  2020 Sep;4(3):91-98. 10.23838/pfm.2020.00072.

Is a hybrid procedure the gold standard in patients with persistent atrial fibrillation?

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Heart Stroke Vascular Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 2Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Abstract

Endocardial radiofrequency catheter ablation is considered to be a useful procedure for paroxysmal atrial fibrillation. However, catheter ablation has difficulties in achieving successful results in patients with persistent or long-standing persistent atrial fibrillation. Currently, the gold standard is surgical ablation (the Cox maze III procedure). However, because surgical ablation requires a sternotomy and extracorporeal cardiopulmonary bypass and has been associated with surgery-related complications, minimally invasive (totally thoracoscopic) and epicardial-endocardial (hybrid) ablation procedures have been developed. This article reviews the primary surgical and hybrid approaches used to treat persistent or long-standing persistent atrial fibrillation.

Keyword

Atrial fibrillation; Catheter ablation; Hybrid; Thoracoscopy
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