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A heart surgeon and an electrophysiologist operate on a heart with persistent AFib.

The Convergent Procedure: Doubling Up Against Persistent AFib

Feb 05, 2020

Have you ever looked out a dirty window on an upper floor of a building and decided it needed a good cleaning? After wiping down just one side, you’ll find that you still can’t see out of the window, and reaching the outside would require a ladder. The same concept applies to treating certain types of atrial fibrillation in the heart. Treating just the inside or outside might not solve the issue, and surgeons may need additional tools to finish the job. However, doctors have combined two procedures to create a hybrid method for handling both sides of the issue. 

What Is Persistent Atrial Fibrillation? 

Atrial fibrillation, also known as AFib, is a heart condition where the atria, the upper parts of the heart, contract irregularly and don’t push blood into the ventricles as they should. Due to irregular pulses sent through the heart, this condition can lead to several heart conditions and increase your risk of stroke. The convergent procedure is a particularly beneficial treatment for two types of AFib: persistent atrial fibrillation and long-standing persistent atrial fibrillation (LSPAF). People with these types tend to have several areas in and on the heart that generate or send out incorrect signals.

How Does the Convergent Procedure Work? 

A cardiothoracic surgeon begins the convergent procedure by making a small incision in the abdomen and inserting a catheter to reach the back of the heart. From there, they use the catheter to burn select areas on the outside of the heart to deactivate them and keep them from producing abnormal signals. This process is known as ablation. Next, an electrophysiologist inserts a catheter through the groin and sends it to the inside of the heart, where they scar any other necessary areas. 

What Are the Benefits of the Convergent Procedure? 

This procedure combines the expertise of the electrophysiologist and the cardiothoracic surgeon to provide a more comprehensive treatment for people with persistent AFib and LSPAF. Additionally, it does not involve making any incisions in the heart, which can lead to shorter recovery times and a reduced risk of complications. According to a study of 28 subjects who underwent the convergent procedure, 87% achieved a normal heart rhythm and 43% were off their AFib medications three months after the surgery. At the six-month mark, 76% of people no longer experienced symptoms nor required prescription drugs. 

Baylor St. Luke’s Medical Center was the first hospital in the Texas Medical Center to offer the convergent procedure. If you haven’t had success in managing persistent AFib or LSPAF with medication or another treatment, schedule an appointment with a CHI St. Luke’s Health cardiologist to determine whether the convergent procedure is right for you. 

Sources: 
NCBI | The convergent procedure: a multidisciplinary atrial fibrillation treatment.
Sages | Convergent Ablation Using A Laparoscopic Technique For The Treatment Of Atrial Fibrillation
Stop Afib | Catheter Ablation for Atrial Fibrillation
American Heart Association | What is Atrial Fibrillation (AFib or AF)?
Stop Afib | Can Catheter Ablation Treat Persistent Atrial Fibrillation