The question referring to the financial costs of one-stage hybrid surgery for atrial fibrillation in countries where reimbursement is limited is relevant in our modern cost–benefit driven society. But your question is out of the context of our manuscript as we never alluded to the financial aspects of the technique.
Costs for one-stage hybrid atrial fibrillation surgery are important as several highly specialised teams are simultaneously involved and specific, quickly changing electrophysiological material is requested.
A financial contribution from the Belgian patient is currently requested for the epicardial ablation part of the procedure in Belgium. This is in contrast with the endocardial ablation part, which is in most cases covered by the patient’s own medical health Insurance.
The evaluation of costs for patients living abroad in Europe is a more complex, more individually and state-regulated matter and is calculated in agreement with our financial department.