Hybrid AFib Ablation Procedure Proves Successful in Repeat Ablation Patients at Hackensack University Medical Center

Cardiac surgeons and electrophysiologists collaborate in new minimally invasive treatment for hard-to-treat patients

Hybrid AFib ablation available at Hackensack University Medical Center gives patients with hard-to-treat atrial fibrillation not responsive to previous conventional ablation a new procedural option for the management of the most difficult to treat arrhythmias. In this novel model, a cardiac surgeon and electrophysiologist work together to access the heart from both the inside and out minimally invasively.

For some patients with atrial fibrillation such as those with long-standing, persistent arrhythmia or those who have multiple prior procedures, traditional catheter ablation does not offer adequate outcomes. Hybrid ablation offers patients an alternative procedure which addresses triggers for atrial fibrillation that could not be addressed by either catheter ablation alone or with surgery. Hackensack University Medical Center performs the highest volume of these procedures in the state.

The hybrid approach can be performed in a single hospitalization, or as a two-visit procedure. When completed in one visit under general anesthesia, experts from multiple specialties collaborate to perform separate parts of the procedure at the same time. A cardiac surgeon accesses the heart from the outside through a small incision under the sternum and enters the pericardial space with a videoscope. A vacuum-assisted radiofrequency device is employed to perform ablation in the posterior (back) wall of the left atrium. Following this, an electrophysiologist accesses the inside of the heart using catheters inserted through veins in the leg to complete the ablation procedure.

Minimally invasively accessing this critical region of the posterior wall of the left atrium along with the catheter ablation has shown effective particularly in difficult-to-treat patients. Selection of the appropriate patient for this procedure can be accomplished in consultation with an electrophysiologist who will then perform procedural planning with the surgical team.

Nearly 30 patients have undergone the procedure at Hackensack University Medical Center. Overall, physicians have seen dramatic clinical results. More than 70% of patients have fully responded, eliminating all AFib and the need for any antiarrhythmic drug therapy. This includes patients with 2-5 prior ablation procedures and also those with long-standing, persistent AFib.