An irregular heartbeat called atrial fibrillation or afib can be treated with several different approaches. McLeod Cardiothoracic Surgeon S. Cary Huber, MD, says that by combining the heart team’s best surgical procedure and another by a cardiology Electrophysiologist, the patient has many benefits. The combined effort is called the “Convergent Procedure”:
Here’s a summary of Dr. Huber’s description:
Ablation refers to removing or electrically disconnecting some of the abnormal electrical connections in the heart that contribute to the atrial fibrillation. There’s different energy sources used to do the ablation. With the convergent procedure we used what’s called radiofrequency (microwave), but in the operating room we sometimes use cryo (freezing) ablation.
Traditionally, each heart specialist offered patients their own specialty’s take on this particular problem. However, it’s been shown in multiple studies that if you evaluate the patient as a team of heart specialists — with everybody contributing their expertise — patient care is improved. So, the Convergent Procedure is an example of the “heart team” concept being applied to arrhythmia issues.
The Convergent Procedure is a new approach to treating atrial fibrillation. It combines the best aspects of the surgical approach with the electrophysiologist’s approach to atrial fibrillation.
Historically, the surgery involved a full sternotomy — a full incision along the front of the chest — to ablate or burn problem tissue. The electrophysiologist’s approach is much less invasive, but has had difficulty with recurrence rates. The Convergent Procedure combines both the surgical and electrophysiologist’s expertise. The surgical approach is a 1-2” incision below the breastbone, where a camera is inserted behind the heart.
The surgeon ablates or burns the tissues on the back of the heart. Then, the electrophysiologist ablates the tissue on the inside of the heart. By marrying these two technologies, with the patient receiving only one anesthetic, we’re able to get better results.
I think that it’s important for people to be aware of the Convergent Procedure. It’s a new minimally invasive procedure for atrial fibrillation. Atrial fibrillation is the most common cardiac arrhythmia in the adult population and causes quite a bit of morbidity. The medications and blood thinner treatments are difficult for some patients to tolerate and this is a potential way for them to get off their medications and, even, blood thinners.