Convergent Procedure

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University Health Heart & Vascular Institute 
210-64-HEART (3278)

Adult Congenital Heart Disease Program 
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Convergent Procedure

The convergent procedure combines minimally invasive heart surgery and catheter ablation to treat atrial fibrillation, a type of irregular heartbeat. This is the first treatment of its kind to treat atrial fibrillation because it’s a mix of surgery and catheter ablation.

What Is the Convergent Procedure?

The goal of this procedure is to create scar tissue on the heart to block harmful electric activity that causes irregular heartbeat. Your surgeon and your electrophysiologist will work together to strategically create scar tissue on different parts of your heart. 

Cardiac catheter ablation uses heat or cold energy to form scars on the heart’s tissue. This blocks irregular electrical activity and restores the regular heartbeat. Catheters, which are small, bendable tubes, are used to access the heart tissue and apply the heat or cold energy needed to create scarring.

Benefits of the Convergent Procedure

When compared to medications only, patients who undergo ablation to treat atrial fibrillation have:

  • 44% less hospitalizations for cardiovascular reasons
  • 58% fewer recurrences of atrial arrhythmias
  • 50% less risk of death for patients who have heart failure
  • A better quality of life

When comparing the convergent procedure to catheter ablation, benefits included:

  • Higher success rate in eliminating atrial fibrillation (63% versus 43%)
  • Higher success of reducing atrial fibrillation burden by >90% (74% versus 55%)
  • Less need for cardioversion (91% versus 74%)

What Happens During the Convergent Procedure

First, your surgeon will make a small incision below your ribcage and insert a scope. Using the scope and specialized instrument she or she will apply direct intense heat to create scar tissue on the outside wall of your heart.  He or she may also close your left atrial appendage, the part of the heart that leads to stroke, at the same time or at a later time.

Your hospital stay will be a few days.  Afterwards, your electrophysiologist will check your heart rhythm.  If you continue to have atrial fibrillation, a “second-stage” non-surgical procedure will be done to treat the remaining areas that are causing the atrial fibrillation.

Who Qualifies for the Convergent Procedure

The convergent procedure may be a good option for patients with persistent atrial fibrillation who have not responded to other treatments.

How to Prepare for Convergent Procedure

Don’t eat or drink anything after midnight on the night before your procedure. 

On the day of your procedure, wear comfortable clothes to the hospital. Leave all jewelry and valuables at home. After you check in, you will change into a gown and we will prepare you for surgery.

Learn more about what to expect during your hospital stay.

Recovery after Convergent Procedure

You will need to stay in the hospital for three to four days following the procedure. 

Immediately after surgery, you’ll be moved to the ICU for monitoring, after which you’ll be moved to a regular patient room.

Refrain from strenuous physical activity for at least two weeks following surgery.

Sources

1. Catheter Ablation Versus Medical Therapy for Atrial Fibrillation
2. Effect of catheter ablation versus antiarrhythmic drugs on atrial fibrillation: A meta-analysis of randomized controlled trials
3. Hybrid Convergent Ablation for the Treatment of Persistent and Long-Standing Persistent AF: Results of CONVERGE Trial

Doctors
  1. Alejandro Velasco De La Cuesta, MD
    Alejandro Velasco De La Cuesta, MD
    Internal Medicine
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  2. Ildiko Agoston, MD
    Ildiko Agoston, MD
    Cardiology Nuclear Cardiology
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  3. Michael Weber, MD
    Vascular Surgery
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