Combination of electrophysiological examination and catheter treatment as well as surgical ablation - the principle of the "best of two worlds". The hybrid procedure is especially suitable for patients with long-standing atrial fibrillation.
People living in Switzerland:
Consultation, second opinions and all treatments are covered by basic health insurance.
Minimally invasive hybrid ablation combines the expertise and technologies of electrophysiology and cardiac surgery into a single procedure. Hybrid ablation thus brings together two treatment strategies:
Each patient’s individual situation determines whether surgical or non-surgical intervention is performed first. Often, the second procedures originally planned are not necessary.
Electrophysiology and Cardiac Surgery
Here at Swiss Ablation, electrophysiologists and cardiologists work closely together to determine the appropriate treatment plan for each patient. We recommend combining endovascular 3D mapping (the three-dimensional visualization of the ECG through measurements within the heart) with epicardial (on the heart’s surface) ablation for patients with complex atrial fibrillation. Before each procedure, the specific treatment combination is discussed in detail with the electrophysiologist and the cardiac surgeon and ultimately implemented as a joint “Heart Team” decision in accordance with the latest guidelines. This approach is unique in Switzerland.
Do you have test results and would like a second opinion, or are you unsure whether you need hybrid ablation? One of our specialists would be happy to take the time to see you during a consultation.
Patients who are suitable candidates for hybrid ablation
Hybrid ablation is particularly suitable for patients with long-standing or complex atrial fibrillation, an enlarged left atrium, and a history of unsuccessful catheter ablation. However, a recurrence following catheter ablation—such as atypical atrial flutter or atrial tachycardia—can also be effectively treated with hybrid ablation. The most important argument in favor of performing ablation is the surgical removal of the left atrial appendage, which allows the patient to discontinue blood thinners after four weeks.
Benefits and Outcomes of Hybrid Ablation
Our experience shows that, even one year after completion of treatment, the hearts of most patients remain in a normal sinus rhythm without the need for medication. There are various ways to perform a hybrid ablation. At Swiss Ablation, we perform what is known as a “staged hybrid” ablation. First, a surgical ablation—that is, isolation of the pulmonary veins—is performed. In a second procedure—if necessary—catheter ablation is performed to close any remaining gaps after the surgery. According to the relevant literature, hybrid ablations have a success rate of over 90% in cases of persistent atrial fibrillation.
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Summary
There are various ways to perform a hybrid ablation for atrial fibrillation, and we at Swiss Ablation advocate the so-called “staged hybrid” approach. This means that electrophysiological and surgical interventions are performed at separate times and only when necessary. This helps avoid unnecessary ablations and thereby increases our patients’ long-term safety without compromising the effectiveness of the ablations. Our focus is on treating patients as effectively as necessary and as gently as possible.
FAQs
What does an electrophysiologist do?
An electrophysiologist is a cardiologist who specializes in cardiac arrhythmias. They typically treat these conditions using catheter ablation: Thin catheters are guided through the femoral vein to the heart to ablate the sites causing the arrhythmias—such as those near the pulmonary veins—from the inside (endocardially), usually under sedation without general anesthesia.
What does a cardiac surgeon do?
A cardiac surgeon specializes in surgical procedures on the heart. In cases of atrial fibrillation, the surgeon works from the outside on the surface of the heart (epicardially), under general anesthesia, through small incisions in the chest wall—for example, during surgical ablation, often combined with the closure of the left atrial appendage using a clip.
What are the fundamental differences between the two approaches?
The electrophysiologist performs minimally invasive procedures from the inside (endocardially) using catheters. The cardiac surgeon performs surgery from the outside (epicardially) on the surface of the heart, under general anesthesia. Both pursue the same goal—pulmonary vein isolation—but use different approaches.
What is hybrid ablation, and how does it combine both specialties?
Hybrid ablation combines both procedures into a single approach: electrophysiological catheter ablation (cardiology) from the inside, and surgical ablation with atrial appendage closure (cardiac surgery) from the outside. At Swiss Ablation, this is performed as “staged hybrid” ablation—first, surgical pulmonary vein isolation, followed, if necessary, by supplemental catheter ablation to close any remaining gaps.
Who decides which procedure to use, and how closely do the specialists work together?
Before each procedure, electrophysiologists and cardiac surgeons at Swiss Ablation jointly discuss the individual treatment plan and make decisions as a “Heart Team” in accordance with the latest guidelines—an approach that, according to the website, is unique in Switzerland.
For which patients is hybrid ablation particularly suitable?
This is particularly true for patients with long-standing or complex atrial fibrillation, an enlarged left atrium, previous unsuccessful catheter therapy, or a recurrence (e.g., atypical atrial flutter, atrial tachycardia) following catheter ablation.
What are the results and benefits of hybrid ablation?
According to Swiss Ablation’s experience, most patients maintain a normal sinus rhythm without medication even one year after treatment. For persistent atrial fibrillation, the success rate is over 90% according to the literature. In addition, surgical closure of the left atrial appendage often allows patients to discontinue blood thinners after four weeks.
Why does Swiss Ablation choose the “staged hybrid” approach instead of a combined one-step procedure?
Because electrophysiological and surgical procedures are performed at separate times and only when truly necessary. This avoids unnecessary ablations, increases long-term patient safety, and ensures treatment that is as effective as necessary but as minimally invasive as possible.
Praxis im Puls 5 Giessereistrasse 18 8005 Zürich Schweiz
