Editor—Hybrid atrial fibrillation surgery consists of simultaneous epicardial and endocardial ablation of the beating heart by thoracoscopy and percutaneous femoral approaches, respectively, without cardiopulmonary bypass support. The epicardial ablation may be bilateral or unilateral. A joint effort of different teams is required: cardiologist, cardiac surgeon, anaesthetists, respiratory therapists, and nurses.1 The cardiopulmonary bypass team is on standby. Anaesthetic considerations for hybrid surgery involve control of perioperative haemodynamic and respiratory stability and postoperative pain control. We review our institutional approach here for the benefit of new programmes.
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