In-hospital complications of hybrid vs endocardial atrial fibrillation ablation

Authors

Mahmoud Eisa, Rochester Regional HealthFollow
Nauman Naeem, Rochester Regional HealthFollow
Hossam Elbenawi
Asmaa Ahmed, Rochester Regional HealthFollow
Andrew Takla, Rochester Regional HealthFollow
Amir Hanafi, Rochester Regional HealthFollow
Abhishek J. Deshmukh
Christopher V. DeSimone
Mohan Rao, Rochester Regional HealthFollow

Department

Internal Medicine

Additional Department

Cardiology

Document Type

Article

Publication Title

Heart Rhythm O2

Abstract

Background: Hybrid atrial fibrillation (AF) ablation has been used to achieve rhythm control in AF management. It requires both epicardial and endocardial ablation. There is limited evidence regarding the safety of this procedure.

Objective: The study aimed to compare in-hospital complication rates between hybrid AF ablation and endocardial catheter ablation (ECA) using a nationally representative dataset.

Methods: Using the National Inpatient Sample, we identified patients who underwent AF ablation between 2017 and 2022. The cohort was divided into 2 groups; those who underwent ECA and those who underwent hybrid AF ablation. The primary outcome was major adverse cardiovascular events (MACEs).

Results: After propensity score weighting, hybrid ablation was associated with a significantly lower MACE rate (3.1% vs 5.6%, P = .0036). Rates of cardiac complications (8.8% vs 7.5%, P = .594), infections (2.7% vs 3.7%, P = .595), and length of stay (2.96 ± 0.30 vs 3.19 ± 2.45 days, P = .285) were comparable between groups. Hybrid ablation was associated with higher rates of hemorrhagic complications (12.7% vs 4.0%, P < .001), with a comparable rate of blood transfusion, whereas pulmonary complications showed a trend toward an increase (3.8% vs 1.5%, P = .099).

Conclusion: Hybrid AF ablation was associated with a significantly lower MACE rate compared with ECA, contrasting with earlier studies that suggested higher risk. This shift likely reflects improvements in technique and more refined patient selection. While rates of pulmonary and hemorrhagic complications were higher with hybrid ablation, transfusion needs remained similar between groups.

First Page

1259

Last Page

1267

DOI

10.1016/j.hroo.2025.05.023

Volume

6

Issue

9

Publication Date

9-1-2025

PubMed ID

41280536

Recommended Citation

Eisa, M., Naeem, N., Elbenawi, H., Ahmed, A., Takla, A., Hanafi, A., Deshmukh, A. J., DeSimone, C. V., & Rao, M. (2025). In-hospital complications of hybrid vs endocardial atrial fibrillation ablation. Heart Rhythm O2, 6 (9), 1259-1267. https://doi.org/10.1016/j.hroo.2025.05.023