Convergent ablation for persistent atrial fibrillation: Single center experience

Area of Science:

• Cardiology
• Cardiac Electrophysiology
• Minimally Invasive Surgery

Background:

• Endocardial catheter ablation is effective for paroxysmal atrial fibrillation (AF) but less so for persistent atrial fibrillation (PAF).
• A hybrid approach combining surgical and catheter ablation is emerging as a potentially more durable treatment for PAF.
• This study reports on the experience with the convergent ablation procedure in a cohort of PAF patients.

Purpose of the Study:

• To evaluate the safety and efficacy of the convergent ablation procedure for treating persistent atrial fibrillation (PAF).
• To assess the recurrence rates and complications associated with the hybrid approach in PAF patients.

Main Methods:

• A single-center retrospective analysis of 31 patients with PAF undergoing the convergent procedure.
• The procedure involved surgical epicardial ablation of the posterior left atrium via a subxiphoid approach, followed by same-day radiofrequency endocardial ablation.
• Patients were monitored post-procedure with electrocardiograms and implanted devices at 6-month intervals.

Main Results:

• Intraoperative sinus rhythm was achieved in all patients.
• At a median follow-up of 17.7 months, Kaplan-Meier analysis showed a 48% recurrence of atrial tachyarrhythmia (AF/atrial flutter) by 2 years.
• The perioperative complication rate was 12.9%.

Conclusions:

• The hybrid convergent procedure appears to be a relatively safe and effective option for managing persistent atrial fibrillation (PAF).
• Further research is necessary to fully elucidate the long-term outcomes of this hybrid approach in PAF patients.