Surgical perspectives in the management of atrial fibrillation

Table 9 Summary of results from studies included looking at the hybrid approach

Procedure	Ref.	Sample size	Mean follow-up period	Outcome	Important findings
Hybrid approach	Kuman et al[55]	A cohort of 7 patients with AF undergoing a hybrid procedure	Follow-up at 3, 6, 9 and 12 mo post-procedure	After a follow-up of 40 ± 3 mo, 6 out of 7 patients were in sinus rhythm	The hybrid approach is a safe and feasible technique to AF ablation
Hybrid approach	Bulava et al[56]	50 consecutive patients with long-standing AF who underwent the procedure	Follow-up at 3, 6, 9 and 12 mo post-procedure and thereafter after every 6 mo	94% of patients were in sinus rhythm, 12 mo after the procedure No arrhythmias were present in any patient after 12 mo	The hybrid approach is extremely effective in maintaining sinus rhythm compared to radiofrequency catheter ablation or surgical ablation alone
Hybrid approach vs Cox-Maze vs epicardial ablation	Je et al[57]	Systematic review of 37 studies with a total of 1877 patients	12 mo	Operative mortality for the Cox-Maze, epicardial ablation and hybrid approach were 0%, 0.5% and 0.9% At 12 mo, rates of sinus rhythm restoration for the above were 93%, 80% and 70% respectively	The Cox-Maze procedure with cardiopulmonary bypass revealed the highest success rate 12 mo post-procedure compared to the hybrid approach and epicardial approach

AF: Atrial fibrillation.