Atrial Fibrillation Clinical Trial
Official title:
Hybrid Thoracoscopic Surgical and Transvenous Catheter Ablation Versus Transvenous Catheter Ablation in Persistent and Longstanding Persistent Atrial Fibrillation
Atrial fibrillation (AF) is the most common cardiac arrhythmia with a lifetime risk of
developing AF of 1 in 4 people aged over 40. Besides hemodynamic compromises stroke remains
the most feared complication of AF with an increase in risk by 5-fold.
Catheter ablation has evolved as a standardized treatment option in paroxysmal AF. Due to the
advanced electrical and structural remodeling the single procedural results of catheter
ablation for persistent and longstanding persistent AF are rather disappointing without a
proven superiority of any applied strategy compared to others. However, repeated catheter
ablation can achieve better results. The surgical (epicardial) approach seems to be more
effective, though still a significant amount of failures exist. Checking the epicardial
ablation lines and if necessary making additional endocardial lines (which is a hybrid
ablation) is expected to be most efficacious in avoiding lesion gaps and providing the most
complete lesion set.
The study objective of this pilot trial is to compare the safety and efficacy of catheter
ablation within 6 months versus a hybrid ablation consisting of endoscopic epicardial surgery
combined with endocardial catheter ablation (performed one-stage) in preventing the
recurrence of atrial fibrillation (AF) in symptomatic, drug refractory patients with
persistent or longstanding persistent atrial fibrillation.
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