Convergent Procedure

In some patients, atrial fibrillation (A-Fib) occurs intermittently, known as paroxysmal A-Fib.  This type is often well-managed with medications or catheter ablation, which blocks the electrical impulses from causing the irregular heartbeat. In other patients, A-Fib can become persistent (lasting up to a year) or long-standing (lasting more than a year). Persistent and long-standing A-Fib are more challenging to treat, and medications and catheter ablation may be less effective in these cases

Historically, the only effective treatment for persistent and long-standing A-Fib was a surgical intervention called the maze procedure. This procedure requires open chest surgery and is typically performed only when patients need heart surgery for another condition. Recently, a new approach has been developed that combines two minimally invasive techniques—one in the cardiovascular operating room and one in the electrophysiology (EP) lab—to address persistent A-Fib. This hybrid approach is known as the convergent procedure.

Historically, the only effective treatment for persistent and long-standing A-Fib was a surgical intervention called the maze procedure. This procedure requires open-chest surgery and is typically performed only when patients need heart surgery for another condition. Recently, a new approach has been developed that combines two minimally invasive techniques—one in the cardiovascular operating room and one in the electrophysiology (EP) lab—to address persistent A-Fib. This hybrid approach is known as the convergent procedure.

The first step of the convergent procedure occurs in the operating room. The surgeon uses a small incision and a tiny camera to ablate, or disrupt, the electrical pathways on the back wall of the heart. During this procedure, the surgeon also places a small clip on the left atrial appendage, a part of the heart where blood clots commonly form, which helps reduce the risk of stroke. The second step takes place in the EP lab, where the electrophysiologist performs a second ablation on the pulmonary veins to complete the treatment and restore normal heart rhythm in most patients.