Arrhythmias & electrophysiology
Long-term outcome of thoracoscopic ablation and radiofrequency catheter ablation for persistent atrial fibrillation as a de novo procedure
Main finding · Atrial tachyarrhythmia recurrenceResult — go to the resultAdjusted hazard ratio 0.869 95% CI 0.618–1.223Authors' conclusion
As a first procedure in persistent AF, thoracoscopic ablation and RF catheter ablation showed comparable efficacy, clinical, and safety outcomes during long-term follow-up.
Study context
- Population
- Patients undergoing first ablation for persistent atrial fibrillation (AF), February 2011 to December 2020matched population n = 306
- Participants
- 575 patients
- Exposure
- Thoracoscopic ablation vs radiofrequency (RF) catheter ablation as first procedure for persistent AF
- Thoracoscopic ablationn = 281
- RF catheter ablationn = 228reference
- Hybrid ablationn = 66
- Outcome
- Atrial tachyarrhythmia recurrence
- Follow-up
- 7-year follow-up
Methodological detailspropensity-score matched
- Propensity-score matched
Main finding
As reported in the abstract
Adjusted hazard ratio
0.869
95% CI 0.618–1.223
P = 0.420
By group
Thoracoscopic ablationvs RF catheter ablation
adjusted HR 0.869 (95% CI 0.618–1.223); P = 0.420
Observational data: associations, not effects.
Further findings
Pulmonary vein gaps at redo procedure
- Pulmonary vein gaps at redo procedure: P < 0.001
Rhythm outcomes, hybrid ablation
- Hybrid ablation showed similar rhythm outcomes vs both thoracoscopic and RF catheter ablation
Safety
| Outcome | Thoracoscopic ablation | RF catheter ablation |
|---|---|---|
| Stroke | 2.7% | 2.5% |
| Total procedural adverse events | 7.1% | 4.8% |
- Stroke: P = 0.603
- Total procedural adverse events: P = 0.374
Original publication
Long-term outcome of thoracoscopic ablation and radiofrequency catheter ablation for persistent atrial fibrillation as a de novo procedure. Europace. Published 5 May 2023. doi:10.
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