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.