RESUMEN
BACKGROUND: Available data suggest the important role of ablation of the left atrial posterior wall and epicardial myocardial layers in rhythm control therapy in patients with persistent drugrefractory atrial fibrillation (AF). However, endocardial ablation is not always effective in transmural substrate modification. The alternative treatment option is minimally invasive hybrid approach (HABL) combining the strengths of surgical and catheter ablation. AIM: This study aimed to assess the periprocedural safety as well as acute and longterm outcomes of HABL for AF. METHODS: This is a retrospective singlecenter study of patients who underwent HABL using the minimally invasive transabdominal approach between July 2009 and January 2020. Demographic inhospital data and 12month followup results were obtained. The number of hospitalizations, cardioversions, reablations, and severe adverse events in a 3year period before and after HABL were compared using data from the national healthcare provider. RESULTS: In total, 158 patients (mean [SD] age, 51.02 [10.67] years) who underwent HABL were included; 61.4% had persistent AF. There was a 4.4% incidence of periprocedural complications without any fatalities. In 66% of patients, additional endocardial substrate modification was needed, in 52.6% on the posterior wall. In the 12month followup, most patients (78.3%) remained free of arrhythmias. There was a significant reduction in the number of hospitalizations (for AF, 1.65 vs 0.54; or any other cause, 2.56 vs 1.31 per patient), cardioversions, and reablations after HABL (all P <0.05). CONCLUSIONS: The hybrid multidisciplinary approach for treatment of AF is a safe and very effective treatment method in longterm followup, which reduces healthcare burden. It could be considered as an alternative therapeutic option especially in patients with persistent AF.