Hybrid Ablation

Hybrid ablation is a minimally invasive treatment for persistent atrial fibrillation (A-Fib) that combines surgical and catheter-based techniques.

When you choose UPMC for your hybrid ablation, you will receive expert care from some of the region's most experienced cardiologists who treat all types of irregular heart rhythms.

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What Is Hybrid Ablation?

Hybrid ablation is a minimally invasive option to treat persistent A-Fib using a combination of surgical and catheter-based techniques.

The procedure, performed by an electrophysiologist and a cardiothoracic surgeon, creates scar tissue inside your heart using a catheter-based technique and on the surface of your heart using a thoracoscopic surgical procedure. The scar tissue helps to "disconnect" the source of the irregular heart rhythm from the rest of your heart, restoring your normal heart rhythm.

What are the benefits of hybrid ablation?

Only a few small chest incisions are required to perform hybrid ablation, which significantly reduces your risk of complications compared to traditional heart surgery. Other benefits of hybrid ablation include:

• Higher success rates and better long-term results when compared to other treatment options.
• Improved quality of life.
• Reduced recovery time.
• Shorter hospital stay.

Conditions we treat with hybrid ablation

• Atrial Fibrillation (AFib).

Why Would I Need Hybrid Ablation?

You may need hybrid ablation if your A-Fib is severe, persistent, and has not responded to other treatments.

Who’s a candidate for hybrid ablation?

You may be a candidate for hybrid ablation if:

• You have had A-Fib for a long time.
• Medications and other treatments have not helped control your A-Fib.
• You are not a candidate for other types of ablation procedures.
• You are at high risk of complications from A-Fib.

Alternatives to hybrid ablation

• Medication, such as beta-blockers, blood thinners, calcium channel blockers, or antiarrhythmic medications.
• Cardioversion, which uses electrical shock to treat a-fib.
• Implantable devices such as a pacemaker which can control heart rhythm.
• MAZE surgery, a surgical treatment that creates a maze of scars in the heart tissue to block faulty electrical impulses.
• Catheter ablation, which uses catheter techniques only to ablate areas of the heart.
• Watchman procedure, a minimally invasive procedure to prevents stroke due to A-fib.

What Are the Risks and Complications of Hybrid Ablation?

Hybrid ablation is a safe and effective procedure when it is performed by an experienced electrophysiologist and cardiac surgeon.

However, there are risks associated with any medical procedure. Risks of hybrid ablation include:

• Bleeding or infection at your incision site.
• Damage to your blood vessels or heart valves.
• Developing a new abnormal heart rhythm.
• Having your heart rhythm get worse.
• Stroke, blood clots, or heart attack.
• Needing an implanted device such as a pacemaker to control heart rhythm.

What Should I Expect From Hybrid Ablation?

Before: How to prepare for hybrid ablation

Your doctor will explain the hybrid ablation procedure to you and give you a chance to ask questions. To prepare for hybrid ablation, you should:

• Tell your doctor if you are sensitive or allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
• Tell your doctor about all medications (prescription and over-the-counter) and herbal or other supplements you are taking.
• Tell your doctor if you have heart valve disease, as you may need to receive an antibiotic before the procedure.
• Tell your doctor if you have a history of bleeding disorders or if you are taking any blood-thinning medications, aspirin, or other medications that affect blood clotting. It may be necessary to stop some of the medications prior to the procedure.
• Fast for a certain period of time prior to the procedure. Your doctor will tell you how long to fast (usually overnight).
• Have any tests that your doctor recommends. For example, your doctor may request a blood test prior to the procedure to determine how long it takes your blood to clot.

On the day of your hybrid ablation procedure, be sure to bring your photo ID and health insurance card(s). Leave valuables such as cash and jewelry at home.

You will stay in the hospital for a few days after your procedure. You should bring toiletries, a robe, slippers, a cell phone and charger, medications, and a change of clothes. You should also arrange for someone to drive you home after you are discharged from the hospital.

How long does hybrid ablation take?

Hybrid ablation procedures typically take 3-4 hours.

During your hybrid ablation

Hybrid ablation involves a surgical procedure and a catheter procedure. You will be given IV medications and will be asleep during the procedure.

During the surgical procedure, your surgeon will make a few small incisions in your chest where he or she will insert surgical tools to perform the ablation. Your surgeon will use radiofrequency electrical energy or super-cooled nitrous oxide to create scar tissue in specific areas on the surface of your heart.

During the catheter procedure, your electrophysiologist will insert catheters into a vein, typically in your groin, and guide them to your heart. These special catheters deliver the energy required to create scar tissue in specific areas inside your heart.

Recovery after hybrid ablation

You will remain in the hospital for a few days following your procedure, so you can be monitored by your doctor and our nursing staff. While you are in the hospital, your doctor will review your medications to determine if any changes or new medications are needed.

How long does it take to recover from hybrid ablation?

You should be able to return to your normal routine two weeks after your procedure. Ask your doctor when you can return to work. You may be instructed not to drive for a certain amount of time after your procedure. It is very important that you see your doctor for follow-up visits as recommended.

When to call your doctor about hybrid ablation complications

You should call your doctor if you are experiencing any unusual symptoms, including:

• Pain, redness, bleeding, drainage, or increased swelling at the insertion site.
• Burning or pain in your chest.
• Rapid or pounding heartbeat.
• Severe pain, coldness, numbness, or discoloration in the limb where the catheter was inserted.
• A fever of more than 100.0°F.
• New or increasing shortness of breath.
• Difficulty breathing.
• Difficulty swallowing, throat pain, or bloody cough.
• Redness or rash on your chest or back.

If any of these symptoms are severe, you should dial 911 immediately.

What’s the prognosis after hybrid ablation?

Most people’s heart rhythm returns to normal after hybrid ablation. However, some people may still need to take their heart rhythm medications. A small number of people may need to have another A-Fib procedure in the future if their abnormal heart rhythm returns.

What’s the success rate of hybrid ablation?

Hybrid ablation restores normal heart rhythm in more than 80 percent of people and has low complication rates.

Why Choose UPMC for Hybrid Ablation?

UPMC physicians perform hundreds of hybrid ablation procedures each year using the latest technology and techniques. If you require additional cardiovascular care, the specialists at UPMC have the skills and experience needed to perform advanced cardiovascular procedures and offer you the latest treatment options.

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By UPMC Editorial Staff. Last reviewed on 2024-10-01.