Hybrid Totally Thoracoscopic Maze and Catheter Ablation for Persistent Atrial Fibrillation: Initial Experience

Adrian W Pick; Emily Kotschet; Stewart Healy; David Adam; Logan Bittinger

doi:10.1016/j.hlc.2023.06.002

Hybrid Totally Thoracoscopic Maze and Catheter Ablation for Persistent Atrial Fibrillation: Initial Experience

Heart Lung Circ. 2023 Sep;32(9):1107-1114. doi: 10.1016/j.hlc.2023.06.002. Epub 2023 Jul 16.

Authors

Adrian W Pick¹, Emily Kotschet², Stewart Healy², David Adam³, Logan Bittinger⁴

Affiliations

¹ Victorian Heart Hospital, Melbourne, Vic, Australia; Cabrini Medical Centre, Melbourne, Vic, Australia; Peninsula Private Hospital, Melbourne, Vic, Australia. Electronic address: pick.adrian@gmail.com.
² Victorian Heart Hospital, Melbourne, Vic, Australia; Cabrini Medical Centre, Melbourne, Vic, Australia.
³ Victorian Heart Hospital, Melbourne, Vic, Australia.
⁴ Victorian Heart Hospital, Melbourne, Vic, Australia; Peninsula Private Hospital, Melbourne, Vic, Australia.

PMID: 37460351
DOI: 10.1016/j.hlc.2023.06.002

Abstract

Atrial fibrillation is now a pandemic in our ageing community. Although James L. Cox devised a surgical procedure with near-universal curative success in 1987, catheter-based interventions have flourished. For persistent atrial fibrillation (AF), however, an isolated endocardial approach has limitations: procedural times are long, carry risk, and the outcomes are not durable. By combining left atrial endocardial and epicardial interventions with staged mapping, we optimise the benefits of both approaches. Our initial series of hybrid ablation for persistent atrial fibrillation reports excellent early outcomes, freedom from complications and excellent success at follow-up.

Keywords: Atrial fibrillation; Catheter ablation; Hybrid procedure; Left atrial appendage occlusion; Persistent AF; Thoracoscopic surgery.