293 posters, 56 videos, 24 topics, 13 sessions, 658 authors, 215 institutions

ISMICS 2025 Annual Meeting

28 - 31 May, 2025 | Istanbul, Turkey

P11

Hybrid Treatment Of Persistent Atrial Fibrillation In The Era Of Robotic Cardiac Surgery: Epicardial Surgical Ablation

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Poster Presenter

Laura Giroletti

Authors

Laura Giroletti, Ascanio Graniero, Eduardo Celentano, Ernesto Cristiano, Matteo Parrinello, Giovanni Albano, Alfonso Agnino

Affiliations

Department of Cardiovascular Surgery, Humanitas Gavazzeni-Castelli, Bergamo, Italy, Department of Cardiac Electrophysiology, Humanitas Gavazzeni-Castelli, Bergamo, Italy., Department of Cardiac Anesthesia, Humanitas Gavazzeni-Castelli, Bergamo, Italy

Part of Topic

Arrhythmia

Hybrid Treatment Of Persistent Atrial Fibrillation In The Era Of Robotic Cardiac Surgery: Epicardial Surgical Ablation

Background

•Hybrid treatment of persistent atrial fibrillation (AF) has been shown to be effective in restoring sinus rhythm.

•The use of robotic technology with its features of magnified vision, precision and dexterity may bring advantages in safety and effectiveness.

•The purpose of this study is to evaluate the clinical outcomes of robotic surgical ablation in the context of hybrid treatment of AF.

Material and Methods

•Between April 2023 and November 2024, 30 patients underwent robotic-assisted epicardial ablation

Surgical technique

•Mono-lateral ventilation with exclusion of the left lung

•Four incision in left chest wall to place the working-port for the robotic instruments/camera and ablation probe (Epi-sense AtriCure radiofrequency device)

•Set of ablation lines:

left pulmonary veins,

left atrial roof and floor,

left atrial posterior wall,

median side of right pulmonary veins

base of the left atrial appendage

Occlusion of the left atrial appendage with the Atriclip (AtriCure) device.

Results

Procedure was successfully performed in all patients without major complications.

Endocardial catheter ablation was performed in 70% of pts: the effectiveness of previous lines of surgical ablation was confirmed in all patients and endocardial ablation of the right pulmonary veins and mitral isthmus was complete.

Six-months follow up was completed in 19 pts, with AF recurrence in only one patient.

Conclusion

Robotic assisted epicardial ablation is proven a safe, feasible and effective technique. Minimizing surgical trauma results in faster patient recovery and shorter hospital stays. The initial results regarding the restoration of sinus rhythm after hybrid ablation are encouraging for the adoption of this strategy