Arrhythmias & electrophysiologyRandomised controlled trial
Left atrial mechanical function following hybrid epicardial–endocardial vs endocardial catheter ablation: A randomized mechanistic trial
- randomized mechanistic trial
- blinded speckle-tracking echocardiography
- primary mechanistic analyses prespecified in patients in sinus rhythm at follow-up
Authors' conclusion
Among patients in sinus rhythm at follow-up, both HA and CA were associated with favorable LA remodeling. No signal of adverse LA remodeling or impaired LA mechanical recovery was observed with HA compared with CA, despite its dual epicardial-endocardial approach.
Study context
- Population
- Patients with persistent atrial fibrillation (AF) undergoing pulmonary vein isolation (PVI) and posterior wall isolation (PWI)randomized, primary mechanistic analysis n = 42 in sinus rhythm at follow-up
- Participants
- 50 patients
- Comparison
- Hybrid ablation (HA) vs catheter ablation (CA) on left atrial (LA) mechanical function
- Primary endpoint
- Between-group difference in post-ablation LA reservoir strain (LASr, %), adjusted for baseline values
- Follow-up
- 6 months
Primary result
As reported in the abstract
- No significant between-group differences were detected after baseline adjustment
- patients in sinus rhythm at follow-up (n = 42)
- baseline-adjusted analysis of covariance with supporting linear mixed-effects models
Secondary outcomes
Sinus rhythm at follow-up · 6 months
P = 0.70
- Sinus rhythm at follow-up — Overall in sinus rhythm
- 84%
Baseline LA function (all patients in AF)
- LASr
- 8.6 ± 3.8%
- LA ejection fraction (LAEF)
- 22.9% ± 7.5%
- LA volume index (LAVi)
- 50.7 ± 10.0 mL/m²
- Between groups
- P > 0.05
LASr, LAEF and LAVi change within groups · 6 months
- Significantly improved in both groups
- all P < .001
Original publication
Left atrial mechanical function following hybrid epicardial–endocardial vs endocardial catheter ablation: A randomized mechanistic trial. Heart Rhythm. Published 2 July 2026. doi:10.1016/j.hrthm.2026.06.036
Summarised from the published abstract; every number is checked against it