Effectiveness and Safety of Hybrid Ablation versus Endocardial Catheter Ablation Alone in Patients with Persistent Atrial Fibrillation: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Background: This systematic review and meta-analysis aimed to compare the efficacy and safety of hybrid ablation versus endocardial catheter ablation in patients with persistent atrial fibrillation. The study focused on observational research, encompassing both case-control and cohort studies, where the terms ‘prospective’ and ‘retrospective’ refer solely to the cohort study timeframes. Methods: A comprehensive search of the PubMed, Embase, Web of Science, and Cochrane Library databases was conducted without any time restrictions. Primary outcomes measured were the long-term success and complication rates. Secondary outcomes included rates of postoperative electrical cardioversion, repeat ablation, procedural duration, and fluoroscopy time. The Newcastle-Ottawa Scale was utilized to assess the quality of the studies included. Results: The analysis revealed that hybrid ablation significantly increased the long-term success rate of atrial fibrillation ablation compared to catheter ablation alone (OR 1.42; 95% CI: 1.05–1.92; p = 0.031). However, hybrid ablation was associated with a greater risk of overall procedural complications (OR 3.51; 95% CI: 2.18–5.64; p < 0.001) and major procedural complications (OR 3.28; 95% CI: 1.43–7.51; p = 0.003). Conversely, hybrid ablation reduced the likelihood of requiring repeat procedures (OR 0.54; 95% CI: 0.33–0.88; p = 0.002) and showed a trend toward lowering the need for postoperative electrical cardioversion (OR 0.71; 95% CI: 0.46–1.09; p = 0.086). No significant publication bias was detected. Conclusions: Hybrid ablation has demonstrated superior long-term efficacy compared to endocardial catheter ablation alone for treating atrial fibrillation but is linked to an elevated risk of complications. Further research is essential to evaluate the safety profile of hybrid ablation and identify the ideal patient population for this approach.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.007 | 0.003 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".