TY - JOUR
T1 - Short and intermediate term outcomes of the convergent procedure
T2 - Initial experience in a tertiary referral center
AU - Tonks, Robert
AU - Lantz, Gurion
AU - Mahlow, Jeremy
AU - Hirsh, Jeffrey
AU - Lee, Lawrence S.
N1 - Publisher Copyright:
© 2020 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery.
PY - 2020
Y1 - 2020
N2 - Purpose: The Convergent procedure is a hybrid, multidisciplinary treatment for symptomatic atrial fibrillation (AF) consisting of minimally invasive surgical epicardial ablation and percutaneous/catheter endocardial ablation. We investigated outcomes following introduction of the Convergent procedure at our institution. Methods: Retrospective study examining single-center outcomes. Demographic, procedural, and post-procedural variables were collected with follow-up data obtained at 3, 6, and 12 months. Results: In all, 36 patients with paroxysmal (11%) or persistent/long-standing persistent (89%) AF underwent the Convergent procedure. 36% also underwent concomitant left atrial appendage (LAA) exclusion by thoracoscopic placement of an epicardial clip. Mean age 60.6 ± 8.0 years with mean arrhythmia burden of 3.9 ± 2.7 years. All patients had failed prior attempts at medical management, 81% had failed prior cardioversion, and 17% had failed prior catheter ablation. Convergent was performed successfully in all patients with no peri-procedural deaths or major complications. At 3 and 12 months, 77.8% and 77.3% of patients, respectively, were free from symptomatic arrhythmia. 65.8% were off anti-arrhythmic medication at 12 months. Conclusions: The Convergent procedure is safe and has good short-and intermedi-ate-term clinical success rates. This unique hybrid approach combines strengths of surgical and catheter ablation and should be part of any comprehensive AF treatment program.
AB - Purpose: The Convergent procedure is a hybrid, multidisciplinary treatment for symptomatic atrial fibrillation (AF) consisting of minimally invasive surgical epicardial ablation and percutaneous/catheter endocardial ablation. We investigated outcomes following introduction of the Convergent procedure at our institution. Methods: Retrospective study examining single-center outcomes. Demographic, procedural, and post-procedural variables were collected with follow-up data obtained at 3, 6, and 12 months. Results: In all, 36 patients with paroxysmal (11%) or persistent/long-standing persistent (89%) AF underwent the Convergent procedure. 36% also underwent concomitant left atrial appendage (LAA) exclusion by thoracoscopic placement of an epicardial clip. Mean age 60.6 ± 8.0 years with mean arrhythmia burden of 3.9 ± 2.7 years. All patients had failed prior attempts at medical management, 81% had failed prior cardioversion, and 17% had failed prior catheter ablation. Convergent was performed successfully in all patients with no peri-procedural deaths or major complications. At 3 and 12 months, 77.8% and 77.3% of patients, respectively, were free from symptomatic arrhythmia. 65.8% were off anti-arrhythmic medication at 12 months. Conclusions: The Convergent procedure is safe and has good short-and intermedi-ate-term clinical success rates. This unique hybrid approach combines strengths of surgical and catheter ablation and should be part of any comprehensive AF treatment program.
KW - Arrhythmia
KW - Atrial fibrillation
KW - Convergent procedure
KW - Hybrid ablation
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U2 - 10.5761/atcs.oa.19-00164
DO - 10.5761/atcs.oa.19-00164
M3 - Article
C2 - 31495813
AN - SCOPUS:85077534509
SN - 1341-1098
VL - 26
SP - 13
EP - 21
JO - Annals of Thoracic and Cardiovascular Surgery
JF - Annals of Thoracic and Cardiovascular Surgery
IS - 1
ER -