# Sequentiële hybride ablatie versus chirurgische CryoMaze bij AF met structurele hartziekte

*geplaatst 2024-02-01 · Atriumfibrilleren · 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 · https://hartvaat.nl/2024/02/01/sequentiele-hybride-ablatie-versus-chirurgische-cryomaze-bij-af-met-structurele-/*

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.

## English: Sequential hybrid ablation vs. surgical CryoMaze alone for treatment of atrial fibrillation: results of multicentre randomized controlled trial.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

---
Bron: 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, https://doi.org/10.1093/europace/euae040. Bijgewerkt 2026-07-03T13:29:49Z. 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.