Effectiveness and safety of simultaneous hybrid thoracoscopic endocardial catheter ablation of atrial fibrillation in obese and non-obese patients

Kevin Phan*, Laurent Pison, Nelson Wang, Aran Kanagaratnam, Tristan D. Yan, Bart Maesen, Jos G. Maessen, Harry J. Crijns, Mark La Meir

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Web of Science)

Abstract

Background: We evaluated the safety and effectiveness of the hybrid thoracoscopic endocardial epicardial ablation technique for the treatment of atrial fibrillation (AF) in obese versus non-obese patients.

Methods: Between January 2010 and January 2015, a cohort of 61 patients were retrospectively identified to undergo ablation of AF as a stand-alone procedure using a thoracoscopic, hybrid epicardial-endocardial technique. All patients underwent continuous 7-day Holter monitoring at 3, 6 months, 1 year and yearly thereafter.

Results: A total of 40% of the obese cohort had persistent or long-standing AF, compared to 54.9% of the non-obese cohort. There were no deaths or conversion to cardiopulmonary bypass required. At 3-year follow-up, 60% of the obese group were in sinus rhythm (SR) with no episode of AF, atrial flutter or atrial tachycardia lasting 30 s off anti-arrhythmic drugs. This was compared to 70.6% in the non-obese group, with no significant difference between the groups (P= 0.468). For success rates on anti-arrhythmic drugs, this was 80% in the obese group compared to 86% in the non-obese group at 3-year follow-up (P= 0.637). No patient died and no thromboembolic/bleeding events or procedure-related complications occurred during the follow-up.

Conclusions: In a retrospective cohort with approximately half with persistent or long-standing AF, thoracoscopic hybrid epicardial endocardial ablation proved to be equally effective and safe in obese versus non-obese patients. Current preliminary findings require further validation in multi-institutional prospective studies with larger sample sizes.

Original languageEnglish
Pages (from-to)3087-3096
Number of pages13
JournalJournal of Thoracic Disease
Volume9
Issue number9
DOIs
Publication statusPublished - Sep 2017

Keywords

  • Atrial fibrillation (AF)
  • obesity
  • hybrid ablation
  • PULMONARY VEIN ISOLATION
  • BODY-MASS INDEX
  • OBSTRUCTIVE SLEEP-APNEA
  • TERM-FOLLOW-UP
  • SURGICAL ABLATION
  • CONTROLLED-TRIALS
  • METAANALYSIS
  • PERSISTENT
  • OUTCOMES
  • IMPACT

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