RAiD 10.26259/ae1d0c82

Hybrid Catheter Ablation and Surgical Ablation as a ‘Bail Out’ Strategy In Patients with Atrial Fibrillation Resistant To Catheter Ablation

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  "title": [
    {
      "text": "Hybrid Catheter Ablation and Surgical Ablation as a ‘Bail Out’ Strategy In Patients with Atrial Fibrillation Resistant To Catheter Ablation",
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      "text": "Description textAtrial fibrillation (AF) is the most common arrythmia increasing the risk of stroke and limiting one’s ability to carry out day to day activities. Catheter ablation uses various forms of energy to ablate aberrant parts of the left atrium, thus restoring a normal rhythm. While this treatment is effective for patients with short-lasting AF, paroxysmal atrial fibrillation (PAF), the outcomes for patients with longer standing AF, persistent AF (PsAF) and long-standing persistent AF (LSPAF), are suboptimal. The Hybrid Catheter Ablation and Surgical Ablation (HyCASA) procedure was developed to treat patients with difficult-to-treat AF. It combines catheter ablation of the endocardium, performed by a cardiologist, with surgical ablation of the epicardium, performed by a cardiothoracic surgeon, in either a staged or concurrent approach. This procedure has the advantage of creating a durable lesion of the posterior left atrium while minimizing the risk of damage to local structures, such as the oesophagus. This procedure has been shown to be more effective than catheter ablation alone for PsAF and LsPAF, with acceptable safety. \nOur primary aim is to investigate the efficacy of the HyCASA procedure in patients with AF who have previously failed at least one catheter ablation and anti-arrythmic drugs. Procedural efficacy will be demonstrated by the proportion of patients who fail the procedure over at least 12 months of follow up time. We will also demonstrate efficacy using AF burden over 12 months, where AF burden is the time spent in AF divided by the total monitoring time. \nThis is important research to conduct because it provides evidence as to whether the HyCASA procedure is a viable option for patients with AF who failed catheter ablation and anti-arrythmic drugs previously.",
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