Introduction
Atrial fibrillation (AF), a frequently encountered clinical dysrhythmia,
accounts for nearly half a million US hospitalizations yearly and has
been reported to increase annual US healthcare costs by $26
billion.1 These detriments have been mitigated by the
maintenance of sinus rhythm with innovative, guideline-supported means
of catheter and surgical ablation.2 The convergent
hybrid procedure demonstrated safe and superior effectiveness compared
to standard catheter ablation for the treatment of persistent and
longstanding persistent atrial fibrillation (LSPAF) in the CONVERGE
trial.3 Apart from this assessment by DeLurgio and
colleagues, few additional contemporary studies define AF populations
who would benefit from the expansion beyond standard pulmonary vein
isolation (PVI).
Furthermore, a recent meta-analysis showed that when the hybrid
procedure was studied, the longest follow-up assessed thus far was only
24 months. The same publication describes only two major studies that
evaluated the use of the hybrid approach utilizing cryoablation; only
one of which utilized it exclusively.4 Clearly,
long-term, ”real-world” evidence to guide the use of
cryotherapy-predominant convergent ablation is lacking. To supplement
this deficit, this retrospective study with up to 48-month-follow-up,
aims to describe a “real-world” AF patient population that can benefit
from hybrid ablation. Furthermore, it will compare the safety and
efficacy observed with this group to a cohort of early AF treated with a
standard, PVI-alone approach.