Hybrid convergent ablation versus endocardial catheter ablation for atrial fibrillation: a systematic review and meta-analysis of randomised control trials and propensity matched studies

Atrial fibrillation (AF) is the most common arrhythmia. Hybrid convergent ablation (HCA) is an emerging procedure for treating longstanding AF with promising results. HCA consists of a subxiphoid, surgical ablation followed by completion endocardial ablation. This meta-analysis of randomized control...

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Bibliographic Details
Published in:Journal of cardiothoracic surgery 2022-08, Vol.17 (1), p.181-10, Article 181
Main Authors: Eranki, Aditya, Wilson-Smith, Ashley R, Williams, Michael L, Flynn, Campbell D, Manganas, Con
Format: Article
Language:English
Subjects:
Ablation
Ablation (Surgery)
Ablation Techniques
Arrhythmia
Atrial fibrillation
Atrial Fibrillation - surgery
Bias
Cardiac arrhythmia
Catheter Ablation - methods
Catheters
Clinical trials
Comparative analysis
Complications
Convergence
Convergent procedure
Endocardium - surgery
Esophagus
Fibrillation
Fistulae
Health aspects
Humans
Hybrid ablation
Injuries
Medical instruments
Meta-analysis
Mortality
Neurological disorders
Patients
Postoperative
Radiofrequency ablation
Review
Systematic review
Tamponade
Treatment Outcome
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Summary:Atrial fibrillation (AF) is the most common arrhythmia. Hybrid convergent ablation (HCA) is an emerging procedure for treating longstanding AF with promising results. HCA consists of a subxiphoid, surgical ablation followed by completion endocardial ablation. This meta-analysis of randomized control trials (RCT's) and propensity score-matched studies aims to examine the efficacy and safety of HCA compared to endocardial catheter ablation (ECA) alone on patients with AF. This review was written in accordance with preferred reporting items for systematic reviews and meta-analyses recommendations and guidance. The primary outcome for the analysis was freedom from AF (FFAF) at final follow up. Secondary outcomes were mortality and significant complications such as tamponade, sternotomy, esophageal injury, atrio-esophageal fistulae post procedurally. Four studies where included, with a total of 233 patients undergoing HCA and 189 patients undergoing ECA only. Pooled analysis demonstrated that HCA cohorts had significantly higher rates of FFAF than ECA cohorts, with an OR of 2.78 (95% CI 1.82-4.24, P 
ISSN:1749-8090
1749-8090
DOI:10.1186/s13019-022-01930-7