Parkridge Medical Center recently became the first hospital in Chattanooga to offer the Convergent Procedure as a treatment for persistent atrial fibrillation, the most prevalent heart rhythm disorder and a condition that can lead to heart failure and stroke.
The minimally invasive modality combines electrophysiological and surgical approaches to restore the heart’s normal rhythm and eliminate the need for long-term antiarrhythmic medications.
During atrial fibrillation, electrical signals originating in the atria disrupt the heart’s normal sinus rhythm. Such electrical misfires cause the atrium to flutter and the ventricles to contract rapidly, preventing effective blood flow through the heart and increasing the risk for clot formation and stroke. While some people experience no signs of atrial fibrillation, others may feel a number of symptoms, including chest pain, dizziness or lightheadedness, heart palpitations, or shortness of breath.
“AF [atrial fibrillation] can be a silent disease,” says Timothy Talbert, M.D., electrophysiologist with Diagnostic Cardiology Group. “At the time of diagnosis, the symptoms might not be severe, but if AF [atrial fibrillation] is left untreated, it can become challenging to cure. The Convergent Procedure allows us to address AF and help prevent stroke and heart failure.”
Talbert and Stephen Martin, a surgeon with the Alliance of Cardiac, Thoracic and Vascular Surgeons, performed the first Convergent Procedure in Chattanooga on Oct. 14 at Parkridge.
The Convergent Procedure leverages the skills of an electrophysiologist, who applies radiofrequency energy to the inside wall of the atrium (endocardial ablation), and a cardiothoracic surgeon, who applies radiofrequency energy, also known as RF, to the outside wall. RF energy creates scar tissue that blocks irregular electrical signals.
The Convergent Procedure’s integrated approach allows for more effective ablation on areas of the heart, such as the left atrium and the pulmonary veins, which are hard to reach via endocardial approaches.
The two-stage Convergent Procedure begins in the operating room, where Martin performs an epicardial ablation through a small incision made just below the patient’s sternum. He guides a scope to the left atrium and uses an RF energy-emitting probe to ablate tissue along the outer wall of the left atrium and around the pulmonary veins – areas where abnormal electrical signals commonly originate.
The second stage occurs in the electrophysiology lab, where Talbert uses an electromagnetic mapping system to construct a three-dimensional model of the chambers of the heart and a detailed map of the heart’s electrical activity. Using this information, Talbert identifies electrically active areas responsible for interrupting the heart’s normal rhythm. He inserts a catheter in the femoral vein through a small incision in the groin, guides the catheter to the left atrium and uses RF energy to ablate the inside wall of the atria.
Patients typically return home the day after the procedure and follow-up with Martin and Talbert at regular intervals to track their progress and to evaluate the need for continued use of antiarrhythmic medications.
While the Convergent Procedure is performed through minimally invasive approaches, it is a complex treatment and is recommended for persistent AF that recurs following traditional endocardial ablation.
Prior to the Convergent Procedure, patients with recurring AF had few options for curative therapy. Long-term regimens of antiarrhythmic medications are often used to keep the heart in sinus rhythm and mitigate stroke risk.
“The Convergent Procedure is the state-of-the-art, least invasive treatment for AF that we perform in hopes of getting people off medications that cause adverse side effects,” Martin said. “AF makes people feel terrible and increases the risk for life-threatening conditions. The Convergent Procedure is a tool we can use to get patients back into sinus rhythm and off medications that reduce their quality of life.”
Source: Parkridge Medical Center