Arrhythmias & electrophysiology

Sequential hybrid ablation vs. surgical CryoMaze alone for treatment of atrial fibrillation: results of multicentre randomized controlled trial

EuropacePublished Randomised controlled trial

Authors' conclusion

Pre-emptively performed catheter ablation after the CryoMaze procedure was safe and associated with higher freedom from AF/AT and improved clinical outcomes.

Study context

Population
Patients with non-paroxysmal atrial fibrillation (AF) undergoing CABG and/or valve repair/replacement with mandatory concomitant CryoMaze
Participants
113 vs 116
Comparison
Sequential hybrid ablation vs CryoMaze alone
  • Hybridn = 113
  • Surgeryn = 116reference
Primary endpoint
Efficacy: first recurrence of AF/AT without class I or III antiarrhythmic drugs (implantable cardiac monitors); clinical: composite of hospitalization for arrhythmia recurrence, worsening HF, cardioembolic event or major bleeding
Follow-up
Median 715 (IQR 528-1072) days
Methodological detailsmulticentre
  • Multicentre

Primary result

As reported in the abstract

median follow-up 715 days

Hybrid Group (HG)

Primary efficacy endpoint
41.1%
Primary clinical endpoint
19.9%

Hybrid Group (HG)

Primary efficacy endpoint41.1%
Primary clinical endpoint19.9%
HGHazard ratio (95% CI)P value
Primary efficacy endpoint; 41.1% vs. 67.4% (Surgery Group)
0.38(0.26–0.57)
P < 0.001
Primary clinical endpoint; 19.9% vs. 40.1% (Surgery Group)
0.51(0.29–0.86)
P = 0.012

Further findings

Trial groups did not differ in all-cause mortality (10.6% vs. 8.6%)
HR = 1.17, 95%CI: 0.51-2.71, P = 0.71

Safety

Major complications of catheter ablation (infrequent)
1.9%

Original publication

Sequential hybrid ablation vs. surgical CryoMaze alone for treatment of atrial fibrillation: results of multicentre randomized controlled trial. Europace. Published 2 February 2024. doi:10.1093/europace/euae040

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