Short and intermediate term outcomes of the convergent procedure: Initial experience in a tertiary referral center

Robert Tonks, Gurion Lantz, Jeremy Mahlow, Jeffrey Hirsh, Lawrence S. Lee

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)13-21
Number of pages9
JournalAnnals of Thoracic and Cardiovascular Surgery
Volume26
Issue number1
DOIs
StatePublished - 2020
Externally publishedYes

Keywords

  • Arrhythmia
  • Atrial fibrillation
  • Convergent procedure
  • Hybrid ablation

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Gastroenterology

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