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Hybrid Convergent ablation for atrial fibrillation: A systematic review and meta-analysis
BACKGROUND: Hybrid Convergent ablation for atrial fibrillation (AF) combines minimally invasive surgical (epicardial) and catheter (endocardial) ablation. The procedural goal is to achieve more extensive, enduring ablation of AF substrate around the pulmonary veins, posterior wall, and vestibule of...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9463711/ https://www.ncbi.nlm.nih.gov/pubmed/36097459 http://dx.doi.org/10.1016/j.hroo.2022.05.006 |
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author | Shrestha, Suvash Plasseraud, Kristen M. Makati, Kevin Sood, Nitesh Killu, Ammar M. Contractor, Tahmeed Ahsan, Syed De Lurgio, David B. Shults, Christian C. Eldadah, Zayd A. Russo, Andrea M. Knight, Bradley Greenberg, Yisachar Jesse Yang, Felix |
author_facet | Shrestha, Suvash Plasseraud, Kristen M. Makati, Kevin Sood, Nitesh Killu, Ammar M. Contractor, Tahmeed Ahsan, Syed De Lurgio, David B. Shults, Christian C. Eldadah, Zayd A. Russo, Andrea M. Knight, Bradley Greenberg, Yisachar Jesse Yang, Felix |
author_sort | Shrestha, Suvash |
collection | PubMed |
description | BACKGROUND: Hybrid Convergent ablation for atrial fibrillation (AF) combines minimally invasive surgical (epicardial) and catheter (endocardial) ablation. The procedural goal is to achieve more extensive, enduring ablation of AF substrate around the pulmonary veins, posterior wall, and vestibule of the posterior wall left atrium. OBJECTIVE: To perform a systematic review and meta-analysis on safety and effectiveness of contemporary Hybrid Convergent procedures. METHODS: PubMed, Embase, and manual searches identified primary research articles on Hybrid Convergent. Inclusion criteria focused on contemporary practices (epicardial ablation device and lesions). Clinical outcomes at 1 year or later follow-up, patient population, procedural details, and major adverse events (MAE) were recorded. RESULTS: Of 249 records, 6 studies (5 observational, 1 randomized controlled trial) including 551 patients were included. Endocardial energy sources included radiofrequency and cryoballoon. Hybrid Convergent ablation was mostly performed in patients with drug-refractory persistent and longstanding persistent AF. Mean preprocedural AF duration ranged between 2 and 5.1 years. Most patients (∼92%) underwent Hybrid Convergent in a single hospitalization. At 1 year follow-up or later, 69% (95% confidence interval [CI]: 61%–78%, n = 523) were free from atrial arrhythmias and 50% (95% CI: 42%–58%, n = 343) were free from atrial arrhythmias off antiarrhythmic drugs. Thirty-day MAE rate was 6% (95% CI: 3%–8%, n = 551). CONCLUSION: Hybrid Convergent ablation is an effective ablation strategy for persistent and longstanding persistent AF. Contemporary procedural approaches and published strategies aim to mitigate complications reported in early experience and address delayed inflammatory effusions. |
format | Online Article Text |
id | pubmed-9463711 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-94637112022-09-11 Hybrid Convergent ablation for atrial fibrillation: A systematic review and meta-analysis Shrestha, Suvash Plasseraud, Kristen M. Makati, Kevin Sood, Nitesh Killu, Ammar M. Contractor, Tahmeed Ahsan, Syed De Lurgio, David B. Shults, Christian C. Eldadah, Zayd A. Russo, Andrea M. Knight, Bradley Greenberg, Yisachar Jesse Yang, Felix Heart Rhythm O2 Clinical BACKGROUND: Hybrid Convergent ablation for atrial fibrillation (AF) combines minimally invasive surgical (epicardial) and catheter (endocardial) ablation. The procedural goal is to achieve more extensive, enduring ablation of AF substrate around the pulmonary veins, posterior wall, and vestibule of the posterior wall left atrium. OBJECTIVE: To perform a systematic review and meta-analysis on safety and effectiveness of contemporary Hybrid Convergent procedures. METHODS: PubMed, Embase, and manual searches identified primary research articles on Hybrid Convergent. Inclusion criteria focused on contemporary practices (epicardial ablation device and lesions). Clinical outcomes at 1 year or later follow-up, patient population, procedural details, and major adverse events (MAE) were recorded. RESULTS: Of 249 records, 6 studies (5 observational, 1 randomized controlled trial) including 551 patients were included. Endocardial energy sources included radiofrequency and cryoballoon. Hybrid Convergent ablation was mostly performed in patients with drug-refractory persistent and longstanding persistent AF. Mean preprocedural AF duration ranged between 2 and 5.1 years. Most patients (∼92%) underwent Hybrid Convergent in a single hospitalization. At 1 year follow-up or later, 69% (95% confidence interval [CI]: 61%–78%, n = 523) were free from atrial arrhythmias and 50% (95% CI: 42%–58%, n = 343) were free from atrial arrhythmias off antiarrhythmic drugs. Thirty-day MAE rate was 6% (95% CI: 3%–8%, n = 551). CONCLUSION: Hybrid Convergent ablation is an effective ablation strategy for persistent and longstanding persistent AF. Contemporary procedural approaches and published strategies aim to mitigate complications reported in early experience and address delayed inflammatory effusions. Elsevier 2022-05-16 /pmc/articles/PMC9463711/ /pubmed/36097459 http://dx.doi.org/10.1016/j.hroo.2022.05.006 Text en © 2022 Heart Rhythm Society. Published by Elsevier Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Clinical Shrestha, Suvash Plasseraud, Kristen M. Makati, Kevin Sood, Nitesh Killu, Ammar M. Contractor, Tahmeed Ahsan, Syed De Lurgio, David B. Shults, Christian C. Eldadah, Zayd A. Russo, Andrea M. Knight, Bradley Greenberg, Yisachar Jesse Yang, Felix Hybrid Convergent ablation for atrial fibrillation: A systematic review and meta-analysis |
title | Hybrid Convergent ablation for atrial fibrillation: A systematic review and meta-analysis |
title_full | Hybrid Convergent ablation for atrial fibrillation: A systematic review and meta-analysis |
title_fullStr | Hybrid Convergent ablation for atrial fibrillation: A systematic review and meta-analysis |
title_full_unstemmed | Hybrid Convergent ablation for atrial fibrillation: A systematic review and meta-analysis |
title_short | Hybrid Convergent ablation for atrial fibrillation: A systematic review and meta-analysis |
title_sort | hybrid convergent ablation for atrial fibrillation: a systematic review and meta-analysis |
topic | Clinical |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9463711/ https://www.ncbi.nlm.nih.gov/pubmed/36097459 http://dx.doi.org/10.1016/j.hroo.2022.05.006 |
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