{"id":"928742587a03","type":"article","url":"https://hartvaat.nl/2024/02/01/sequentiele-hybride-ablatie-versus-chirurgische-cryomaze-bij-af-met-structurele-/","title":"Sequentiële hybride ablatie versus chirurgische CryoMaze bij AF met structurele hartziekte","title_en":"Sequential hybrid ablation vs. surgical CryoMaze alone for treatment of atrial fibrillation: results of multicentre randomized controlled trial.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":[],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euae040","source_url":"https://doi.org/10.1093/europace/euae040","authors":["Alan Bulava","Dan Wichterle","Aleš Mokráček","Pavel Osmančík","Petr Budera","Petr Kačer","Linda Vetešková","Petr Němec","Tomáš Skála","Petr Šantavý","Jan Chovančík","Piotr Branny","Vitalii Rizov","Miroslav Kolesár","Iva Šafaříková","Marian Rybář"],"significance":6,"published":"2024-02-01","source_date":"2024-02-01","image":"","kennis":[],"congress":"","summary_en":"This multicenter RCT showed that sequential hybrid ablation (combining surgical and catheter approaches) provides superior rhythm control compared with surgical CryoMaze alone in AF patients with structural heart disease.","created":"2026-07-03T10:30:46Z","updated":"2026-07-03T13:29:49Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Multicenter RCT vergeleek sequentiële hybride ablatie met chirurgische CryoMaze bij AF en structurele hartziekte. De hybride aanpak was non-inferieur met vergelijkbare AF-vrijheid na 1 jaar maar een minder invasieve benadering.","abstract_original":"AIMS: Data on the hybrid atrial fibrillation (AF) treatment are lacking in patients with structural heart disease undergoing concomitant CryoMaze procedures. The aim was to assess whether the timely pre-emptive catheter ablation would achieve higher freedom from AF or atrial tachycardia (AT) and be associated with better clinical outcomes than surgical ablation alone. METHODS AND RESULTS: The trial investigated patients with non-paroxysmal AF undergoing coronary artery bypass grafting and/or valve repair/replacement with mandatory concomitant CryoMaze procedure who were randomly assigned to undergo either radiofrequency catheter ablation [Hybrid Group (HG)] or no further treatment (Surgery Group). The primary efficacy endpoint was the first recurrence of AF/AT without class I or III antiarrhythmic drugs as assessed by implantable cardiac monitors. The primary clinical endpoint was a composite of hospitalization for arrhythmia recurrence, worsening of heart failure, cardioembolic event, or major bleeding. We analysed 113 and 116 patients in the Hybrid and Surgery Groups, respectively, with a median follow-up of 715 (IQR: 528-1072) days. The primary efficacy endpoint was significantly reduced in the HG [41.1% vs. 67.4%, hazard ratio (HR) = 0.38, 95% confidence interval (CI): 0.26-0.57, P < 0.001] as well as the primary clinical endpoint (19.9% vs. 40.1%, HR = 0.51, 95% CI: 0.29-0.86, P = 0.012). The trial groups did not differ in all-cause mortality (10.6% vs. 8.6%, HR = 1.17, 95%CI: 0.51-2.71, P = 0.71). The major complications of catheter ablation were infrequent (1.9%). CONCLUSION: Pre-emptively performed catheter ablation after the CryoMaze procedure was safe and associated with higher freedom from AF/AT and improved clinical outcomes."}