New physician experience for the Convergent Procedure in the treatment of persistent atrial fibrillation (AF) was presented during a podium talk at the Northeast Cardiothoracic Surgical Society 20th Annual Meeting held last week in East Madison, NH. William M. Boedefeld II, MD, of CVT Surgical Center in Baton Rouge, LA, reported on 224 patients, 66% of whom had persistent or longstanding persistent AF and 34% who had paroxysmal AF. At 1-year follow-up, 93% of patients were in sinus rhythm.
"The Convergent Procedure is our first-line treatment for AF patients with enlarged atria," stated Dr. Boedefeld. "For patients with enlarged atria where we may anticipate a second procedure with traditional catheter ablation, even in paroxysmal AF patients, we see the Convergent Procedure as the best opportunity for single-procedure results. The key clinical advantage is the ability to electrically silence the heart's posterior wall, where the majority of AF triggers are known to reside. We achieve this through a minimally invasive procedure, under direct visibility. Our electrophysiology partners can then complete the procedure in the same EP lab setting – our average total procedure time is 3.95 hours."
The multidisciplinary Convergent Procedure is performed as a single procedure in the electrophysiology lab. The epicardial lesions are created first under direct endoscopic visualization by a surgeon, through a 2 cm incision in the abdomen, with no chest incisions or ports. The endocardial lesions created by an electrophysiologist ensure lesion set completeness, and specialized EP mapping and diagnostics provide the checks and balances to ensure a comprehensive approach.
"The Convergent Procedure addresses the progressive nature of AF," said Kenneth C. Civello Jr., MD, MPH, of Our Lady of the Lake Regional Medical Center in Baton Rouge, LA. "Standardized, comprehensive ablation of the posterior wall can result in reverse remodeling where the overall atrial volume can be reduced, and function can improve. This allows us to use the Convergent Procedure for all patients with enlarged atria. Patients can then be provided customized care within a long-term Disease Management Program."