Arrhythmias & electrophysiologyMeta-analysis
Short- and long-term outcomes in isolated vs. hybrid thoracoscopic ablation in patients with atrial fibrillation: a systematic review and reconstructed individual patient data meta-analysis
- Systematic review and reconstructed individual patient data meta-analysis
- multivariable Cox frailty model
Authors' conclusion
Hybrid thoracoscopic AF ablation is associated with a greater long-term freedom from ATA when compared with isolated thoracoscopic ablation, without differences in complications.
Study context
- Population
- Patients with (long-standing) persistent atrial fibrillation (AF)
- Participants
- 4,950 patients · 53 studies
- Comparison
- Hybrid thoracoscopic vs isolated thoracoscopic AF ablation
- Outcome
- Long-term freedom from atrial tachyarrhythmias (ATA)
Pooled result
As reported in the abstract
Long-term freedom from ATA (18 studies, 2038 patients)
Adjusted hazard ratio
0.59
95% CI 0.43–0.83
P < 0.001
Hybrid thoracoscopic ablation vs Isolated thoracoscopic ablation
aHR 0.59 (95% CI 0.43–0.83); P < 0.001
Further pooled results
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| Predictors of lower long-term freedom from ATA recurrence — Older age vs Isolated thoracoscopic ablation | 1.07 (1.03–1.12) | P = 0.002 | |
| Predictors of lower long-term freedom from ATA recurrence — Higher percentage of male patients vs Isolated thoracoscopic ablation | 1.02 (1.01–1.03) | P < 0.001 | |
| 0.512Adjusted hazard ratio (log scale) |
Safety
Major short-term outcomes (mortality or stroke)
- No differences between isolated and hybrid thoracoscopic ablation
Original publication
Short- and long-term outcomes in isolated vs. hybrid thoracoscopic ablation in patients with atrial fibrillation: a systematic review and reconstructed individual patient data meta-analysis. Europace. Published 10 September 2024. doi:10.1093/europace/euae232
Summarised from the published abstract; every number is checked against it