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Doctors & patients are saying about 'Beat Your A-Fib'...


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Walter Kerwin, MD, Cedars-Sinai Medical Center, Los Angeles, CA


AF Symposium New Report: Live! Convergent Hybrid Ablation for Atrial Fibrillation

Background: The Convergent Hybrid Ablation is currently used for patients with persistent and longstanding persistent atrial fibrillation.
The Hybrid is performed under general anesthesia. First the surgeon accesses the outside (epicardial) of the heart and creates lesions on the posterior left atrial wall and around the pulmonary veins (PVs). Next, the EP performs a standard PV catheter ablation from inside (endocardial) the heart, uses mapping systems to detect any gaps in the surgical ablation lines, and completes the surgeon’s lesion set, if needed.

Via live streaming video, AF Symposium attendees got to watch a Convergent Hybrid operation/procedure performed from Emory Heart and Vascular Center at Saint Joseph’s Hospital, Atlanta, GA.

PATIENT DESCRIPTION: A DIFFICULT CASE

The patient was a 62-year-old man who had been in A-Fib for 21 years, 10 years of those in persistent A-Fib. He was also very tall. He also complained of being very fatigued.

They didn’t know the amount of fibrosis the patient had developed. They mentioned that they hoped the fibrosis was localized rather than diffuse and that the patient did not have a Utah 4 or a Strawberry-type of large fibrosis area. (About Utah and fibrosis, see High Fibrosis at Greater Risk of Stroke and Precludes Catheter Ablation)

The patient had been on rate control drugs and the antiarrhythmic Sotalol. It was not mentioned if anyone had ever tried a normal catheter ablation on this patient before going to the Convergent operation/procedure.

Phase I: SURGERY ON OUTSIDE OF HEART

In this version of the hybrid, the cardiothoracic surgeon accesses the outside posterior of the heart through the subxiphoid process cutting through the central tendon of the soft tissue of the diaphragm making a 2-3 cm incision.

Important: Read my extensive Editor’s Comments at the end of this report.

The surgeon achieves direct vision of the posterior cardiac structure with a miniature camera (from EnSight by AtriCure). (The xiphoid process is a cartilaginous section at the lower end of the sternum.)… Continue reading my new report from the 2019 AF Symposium->

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