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Review
. 2021 Oct;10(3):198-204.
doi: 10.15420/aer.2021.24.

Hybrid Convergent Procedure for the Treatment of Persistent and Long-standing Persistent Atrial Fibrillation

David B DeLurgio  1 , Jaswinder S Gill  2 , Syed Ahsan  3 , Riyaz A Kaba  4 , Kristen M Plasseraud  5 , Michael E Halkos  1
Affiliations
Review

Hybrid Convergent Procedure for the Treatment of Persistent and Long-standing Persistent Atrial Fibrillation

David B DeLurgio et al. Arrhythm Electrophysiol Rev. 2021 Oct.

Abstract

Recent advances have been made in AF treatment, including the role of early rhythm control and landmark clinical trials using ablation therapy. However, some treatment gaps remain, including the creation of durable lesions outside the pulmonary veins and effective treatment of longstanding persistent AF. A novel epicardial-endocardial ablation approach - the hybrid convergent procedure - was developed to combine surgical and catheter ablation techniques into a collaborative, multidisciplinary approach to managing AF. In this review, the authors discuss recently published data on hybrid convergent ablation, including results of the CONVERGE clinical trial, in the context of current challenges to treatment of persistent and long-standing persistent AF. The review also aims to provide perspective on outstanding questions and future directions in this area.

Keywords: Hybrid ablation; endocardial; epicardial; hybrid convergent; long-standing persistent atrial fibrillation; persistent atrial fibrillation.

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Conflict of interest statement

Disclosure: DBD is a consultant and on speakers bureaux for AtriCure and Boston Scientific, and is a consultant to Medtronic. JSG holds research funding from Abbott (St Jude Medical) and speaker honoraria from AtriCure. SA is on speakers bureaux for AtriCure, Biosense Webster and Boston Scientific. RAK is a consultant for AtriCure and Biotronik and on speakers bureaux for Daiichi Sankyo and Bayer. KMP is an employee with stock ownership at AtriCure. MEH has consulted and is a member of the advisory board for Medtronic and has received compensation for services from AtriCure.

Figures

Figure 1:
Figure 1:. Surgical Approach to Epicardial Ablation
Figure 2:
Figure 2:. Left Atrial Posterior Wall and Pulmonary Vein Isolation After Hybrid Convergent Ablation
Figure 3:
Figure 3:. Contemporary CONVERGE Lesion Set
See this image and copyright information in PMC

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