Hybride Approach for Treatment of Lone Persistent Atrial Fibrillation

Ales Mokracek ¹, Alan Bulava ², Vojtech Kurfirst ¹, Jirii Hanis ¹, Ladislav Pesl ³

¹ Hospital Ceske Budejovice, Ceske Budejovice, Czechia; ² Hospital Ceske Budejovice, University of South Bohemia, Ceske Budejovice, Czechia; ³ Hospital Ceske Budejoviced, Ceske Budejovice, Czechia;

Date, time and location: 2018.05.26 08:30, Congress Hall, 2F–A

Abstract

Objectives: Atrial fibrillation (AF) is risk factor for quality and lenght of the life. Conservative and electrophysiological treatment is not succesfull enought. Alternative approach is combination of surgery and electrophysiology (hybride) and we present our results.

Metods:  In seventy patiens on persistent or long term persistent AF we performed procedure and et least one year follow up (935±432 patient/days, range 346-1509 days). Surgery step was thorascopic isolation of pulmonary veins, box lesion, trigone lesion, ablation of GPs, interruption of Marsal ligament, lesion to CS and ± íntercaval lesion. 2-3 months later we performed electroanatomical mapping and ablation (EAM).

Results: 76% of patiens were on sinus rhythm before EAM. Arrhythmia-free survival off antiarrhythmic drugs 12 months after EAM was 77%. Using antiarrhythmic drugs or reablation, arrhythmia-free survival was 97%. The highest frequency of arrhythmia episodes was in first 12 months after EAM.

Conclusions: We demonstrate  that our hybride treatment option of persistent atrial fibrillation is very effective and give us promissing posibility how we could cure AF resistent on less invasive approaches.