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For the teams delivering hybrid ablation

Persistent AF is best treated by cardiac surgery and electrophysiology working together, not apart. See how we classify candidates for hybrid ablation, why its essential and hear from the clinicians already running these programmes.








Classification of patients undergoing hybrid ablation approaches

Hy5 Type 1:

previously failed catheter ablations (CA)

Hy5 Type 2:

de novo ablation, access route problems (IVC, ASD occluder, Cava filter)

Hy5 Type 3:

de novo ablation, high risk for recurrence after CA (HCM, long-standing per)

Hy5 Type 4:

de novo, persistent/long-standing pers., staged approach with surgical first and CA second (4-6 weeks), including LAAO, VOM + Remapping, CTI, ILR.











Why is CS/EP collaboration essential?

No single approach can fully address complex atrial fibrillation.

By combining surgical access with electrophysiological insight, CS/EP collaboration enables more complete treatment — reducing the need for repeat procedures and improving the likelihood of durable success.


3-7x
repeat ablations often needed for long-standing AF¹
2x
success rate in hybrid approach¹
73-80%
freedom from AF at 12 months in hybrid approach¹


1. Effectiveness and Safety of Hybrid Epicardial and Endocardial Ablation versus Endocardial Ablation in Patients with Persistent and Long-standing Persistent Atrial Fibrillation: a randomized, controlled trial. https://doi.org/10.1016/j.eclinm.2023.102052
24-months data was presented at EHRA 2024.





Resources



Penditure™ Implantantion Endoscopically in Hy5 Procedure



Penditure™ Implantation Open Chest in Concomitant Procedures



Penditure™ Implantation Through the Transverse Sinus in Minimally Invasive Mitralvalve Surgery



Quality of life



Medication and Cardioversion



Patient information


OR



Ablation and Alternatives



Symptoms



What is Hy⁵



How does the Hy⁵ procedure work



Anesthesiologist perspective



Evidence



History of interdisciplinary collaboration









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Connect with other CS/EP teams

Connect with the cardiac surgeons and electrophysiologists already running hybrid ablation programmes elsewhere — share what’s working, ask what isn’t, and learn from centers further along the curve.

Visit forum






View all Hy⁵ centers

There are six Hy⁵ centers throughout Germany that treat this patient population using the Hy⁵ collaborative approach, within the heart team.

Refer your patient here