Abstract 12964: Staged versus Same-Day Thoracoscopic Hybrid Ablation for Persistent Atrial Fibrillation: Identification of Pulmonary Vein Reconnection Following Surgical Ablation

Introduction: Totally thoracoscopic (TT) epicardial ablation combined with endocardial catheter ablation is an emerging approach to treat persistent atrial fibrillation (AF). Catheter ablation is associated with frequent pulmonary vein (PV) reconnection bringing its durability into question despite acute procedural endpoints. Little is known of PV reconnection post TT PV isolation (PVI). Endocardial mapping following TT PVI may shed light on when best to identify PV reconnections. Hypothesis: A staged approach to TT hybrid AF ablation increases the likelihood of discovering PV reconnection compared to same day hybrid, allowing time for resolution of edema and inflammation which transiently impede PV conduction after surgical ablation. Methods: We compared efficacy of thoracoscopic PVI in persistent AF patients undergoing same day vs. staged (>48 Hr delay) hybrid AF ablation at Vanderbilt Hospital. Univariate and multivariate analysis was performed comparing patients with any PV reconnection vs. those with...