Hybrid Ablation of Atrial Fibrillation

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The cornerstone of atrial fibrillation (AF) is electrical isolation of the pulmonary veins (PV). In patients with non-paroxysmal AF, PV isolation alone is insufficient and one needs to modify the atrial arrhythmogenic substrate. AF ablation is mostly performed using a transvenous, endocardial approach with catheters. This technique enables one to characterize the underlying substrate in order to tailor the ablation procedure but these ablation lesions are not always transmural nor long lasting. Thoracoscopic surgical AF ablation techniques, on the other hand, create more reliable linear lesions but the lesion set is based on empirical assumptions rather than specific patient characteristics. Performed in combination (hybrid AF ablation), both approaches are complementary as they overcome their mutual shortcomings.

Conference Alert

Maastricht AF: Crossing Borders, 6th Edition
April 1-3 2015, Maastricht, The Netherlands

This year's edition of the Maastricht AF meeting Maastricht AF: Crossing Borders, 6th Edition will give the floor to expert opinions on the impact of what has been achieved so far with Hybrid AF ablation procedures for patients with complex atrial fibrillation and the way to go in the near future.

For further details please visit the website: www.hybridafmaastricht.nl


Laurent Pison

Laurent Pison

Educational Objectives

  • Atrial fibrillation pathophysiology
  • Historical outcomes of endocardial and surgical AF ablation
  • Hybrid atrial fibrillation ablation: techniques, indications and results

Target Audience

  • Cardiologists
  • Electrophysiologists
  • Cardiac surgeons

Faculty Biographies

Laurent Pison

Laurent Pison

Maastricht University Medical Center,NL

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Key References

1. Schotten U, Verheule S, Kirchhof P, Goette A. Pathophysiological mechanisms of atrial fibrillation: A translational appraisal. Physiological reviews. 2011;91:265-325

2. Calkins H, Kuck KH, Cappato R, Brugada J, Camm AJ, Chen SA, Crijns HJ, Damiano RJ, Jr., Davies DW, DiMarco J, Edgerton J, Ellenbogen K, Ezekowitz MD, Haines DE, Haissaguerre M, Hindricks G, Iesaka Y, Jackman W, Jalife J, Jais P, Kalman J, Keane D, Kim YH, Kirchhof P, Klein G, Kottkamp H, Kumagai K, Lindsay BD, Mansour M, Marchlinski FE, McCarthy PM, Mont JL, Morady F, Nademanee K, Nakagawa H, Natale A, Nattel S, Packer DL, Pappone C, Prystowsky E, Raviele A, Reddy V, Ruskin JN, Shemin RJ, Tsao HM, Wilber D, Heart Rhythm Society Task Force on C, Surgical Ablation of Atrial F. 2012 hrs/ehra/ecas expert consensus statement on catheter and surgical ablation of atrial fibrillation: Recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design: A report of the heart rhythm society (hrs) task force on catheter and surgical ablation of atrial fibrillation. Developed in partnership with the european heart rhythm association (ehra), a registered branch of the european society of cardiology (esc) and the european cardiac arrhythmia society (ecas); and in collaboration with the american college of cardiology (acc), american heart association (aha), the asia pacific heart rhythm society (aphrs), and the society of thoracic surgeons (sts). Endorsed by the governing bodies of the american college of cardiology foundation, the american heart association, the european cardiac arrhythmia society, the european heart rhythm association, the society of thoracic surgeons, the asia pacific heart rhythm society, and the heart rhythm society. Heart rhythm : the official journal of the Heart Rhythm Society. 2012;9:632-696 e621

3. Pison L, Dagres N, Lewalter T, Proclemer A, Marinskis G, Blomstrom-Lundqvist C. Surgical and hybrid atrial fibrillation ablation procedures. Europace.14:939-941

4. Pison L, La Meir M, van Opstal J, Blaauw Y, Maessen J, Crijns HJ. Hybrid thoracoscopic surgical and transvenous catheter ablation of atrial fibrillation. J Am Coll Cardiol. 2012 Jul 3;60(1):54-61.