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

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

Karan Wats  1 , Andy Kiser  2 , Kevin Makati  3 , Nitesh Sood  4 , David DeLurgio  5 , Yisachar Greenberg  1 , Felix Yang  1
Affiliations
Review

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

Karan Wats et al. Arrhythm Electrophysiol Rev. 2020 Aug.

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.

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Conflict of interest statement

Disclosure: AK, KM, NS, DD, YG and FY received consulting fees from Atricure. All other authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Epicardial and Endocardial Lesions of the Convergent Procedure
Figure 2:
Figure 2:. Evolution of the Convergent Procedure
Figure 3:
Figure 3:. Transabdominal and Subxiphoid Approaches
Figure 4:
Figure 4:. AtriClip Application to Electrically and Mechanically Isolate the Appendage
See this image and copyright information in PMC

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