The Convergent Atrial Fibrillation Ablation Procedure: Evolution of a Multidisciplinary Approach to Atrial Fibrillation Management

Karan Wats; Andy Kiser; Kevin Makati; Nitesh Sood; David DeLurgio; Yisachar Greenberg; Felix Yang

doi:10.15420/aer.2019.20

The Convergent Atrial Fibrillation Ablation Procedure: Evolution of a Multidisciplinary Approach to Atrial Fibrillation Management

Arrhythm Electrophysiol Rev. 2020 Aug;9(2):88-96. doi: 10.15420/aer.2019.20.

Authors

Karan Wats¹, Andy Kiser², Kevin Makati³, Nitesh Sood⁴, David DeLurgio⁵, Yisachar Greenberg¹, Felix Yang¹

Affiliations

¹ Maimonides Medical Center, Brooklyn, New York, NY, US.
² St Clair Cardiovascular Surgical Associates, Pittsburgh, PA, US.
³ Tampa Cardiac Specialists, Lutz, FL, US.
⁴ Southcoast Health, Fall River, MA, US.
⁵ Emory Saint Joseph's Hospital, Atlanta, GA, US.

Abstract

The treatment of AF has evolved over the past decade with increasing use of catheter ablation in patients refractory to medical therapy. While pulmonary vein isolation using endocardial catheter ablation has been successful in paroxysmal AF, the results have been more controversial in patients with long-standing persistent AF where extrapulmonary venous foci are increasingly recognised in the initiation and maintenance of AF. Hybrid ablation is the integration of minimally invasive epicardial ablation with endocardial catheter ablation, and has been increasingly used in this population with better results. The aim of this article was to analyse and discuss the evidence for the integration of catheter and minimally invasive surgical approaches to treat AF with specific focus on convergent ablation and exclusion of the left atrial appendage using a surgically applied clip.

Keywords: AF; AtriClip; ablation; convergent procedure.

Publication types

Review