Subgroup analysis demonstrated similar trends , with higher freedom from AF in the surgical ablation group for paroxysmal AF patients .
The incidence of pacemaker implantation was higher , while no difference in stroke or cardiac tamponade was demonstrated for the surgical versus catheter ablation groups .
Current evidence suggests that epicardial ablative strategies are associated with higher freedom from AF , higher pacemaker implantation rates and comparable neurological complications and cardiac tamponade incidence to catheter ablative treatment .
BACKGROUND Atrial fibrillation ( AF ) is an increasingly prevalent condition in the ageing population , with significantly associated morbidity and mortality .
Surgical and catheter ablative strategies both aim to reduce mortality and morbidity through freedom from AF .
This review consoli date s all currently available comparative data to evaluate these two interventions .
Minimally Invasive Surgical Versus Catheter Ablation for the Long-Lasting Persistent Atrial Fibrillation
Objective To assess the efficacy of video-assisted minimally invasive surgical vs. catheter ablation for the long-st and ing persistent AF . Methods We performed a retrospective comparative analysis in a series of 166 long-st and ing persistent AF patients treated between 2006 and 2009 with either video-assisted minimally invasive ablation ( 83 patients ) , or catheter ablations ( 83 patients ) . The catheter group was screened using a ‘ pair-matched case-control ’ methodology in order to select appropriate statistical comparison c and i date s out of 169 long-st and ing persistent AF patients which were potentially suitable for surgery , but have been treated with catheter approaches in order to balance major prognostic factors between the two groups . Follow-up for all patients ranged from 1 to 3.6 years . Results No patient died postoperatively . One patient suffered from stroke in the surgical group but recovered before discharge . Freedom from AF was obtained in 59.0 % and 74.7 % during follow-up in the catheter group and the surgical group respectively ( P = 0.047 ) . Patients in the catheter group had a significantly higher rate of recurrent arrhythmia ( P = 0.011 , hazard ratio : 0.555 , 95 % CI : 0.354 to 0.872 ) compared with the surgically treated group . The freedom from antiarrhythmic drugs was 44.6 % in the catheter group and 61.4 % in the surgical group ( P = 0.043 ) . Conclusions The video-assisted minimally invasive ablation was safe and effective , and had an optimistic success rate for patients with long-st and ing persistent AF in our retrospective comparative study . Thus , further r and omized studies addressing this issue seem to be justified
Subgroup analysis demonstrated similar trends , with higher freedom from AF in the surgical ablation group for paroxysmal AF patients .
The incidence of pacemaker implantation was higher , while no difference in stroke or cardiac tamponade was demonstrated for the surgical versus catheter ablation groups .
Current evidence suggests that epicardial ablative strategies are associated with higher freedom from AF , higher pacemaker implantation rates and comparable neurological complications and cardiac tamponade incidence to catheter ablative treatment .
BACKGROUND Atrial fibrillation ( AF ) is an increasingly prevalent condition in the ageing population , with significantly associated morbidity and mortality .
Surgical and catheter ablative strategies both aim to reduce mortality and morbidity through freedom from AF .
This review consoli date s all currently available comparative data to evaluate these two interventions .