Data presented at HRS 2012 suggest Convergent Procedure ablation may restore persistent atrial fibrillation patients to normal sinus rhythm


nContact has announced that new long-term physician data demonstrated promising clinical outcomes for the multidisciplinary Convergent Procedure in the treatment of persistent atrial fibrillation (AF), with over 80% of patients remaining in sinus rhythm at a minimum of 12 months follow-up. The data was presented by different physicians at Heart Rhythm 2012, the Heart Rhythm Society’s 33rd Annual Scientific Sessions (Boston., USA, 9–12 May).

During the oral abstract sessions, a presentation entitled: “Combined epicardial and endocardial ablation for atrial fibrillation: Single center experience in 100 consecutive patients” by Kenneth C Civello (Our Lady of the Lake Medical Center, Baton Rouge, USA) highlighted clinical outcomes from 104 consecutive patients treated with the Convergent Procedure. Of these, 73% suffered with persistent or permanent AF. Results demonstrated that 86% of patients who reached six months follow-up were in sinus rhythm, with 78% in sinus rhythm off anti-arrhythmic drugs (AADs). Of the 40 patients who have reached 12 month follow-up, 81% were in sinus rhythm, with 69% in sinus rhythm off AADs.

“The combined endocardial and epicardial approach enabled by the Convergent Procedure allows physicians to more efficiently achieve complete, transmural lesions across the posterior of the heart, which research demonstrates is key to adequately addressing this challenging condition,” said Civello. “We feel this multidisciplinary approach is a viable treatment option for persistent patients and is an essential component of our EP toolbox.”

David M Gilligan, Levinson Heart Hospital at CJW Medical Center, Richmond, USA, reviewed data from a prospective registry of the first 39 patients to undergo ablation with the Convergent Procedure at a single centre, 79% of whom suffered with persistent or longstanding persistent AF. At 12 months post procedure, 96% of patients were in sinus rhythm with nearly 70% in sinus rhythm off AADs.

“We incorporated the Convergent Procedure at our centre as a collaboration between surgeons and electrophysiologists, and have seen promising clinical outcomes. Our experience suggests this combined approach may offer a viable treatment option for patients with persistent AF by maintaining sinus rhythm after a single ablation procedure,” said Gilligan.

A poster presented by Keith M Golden (St Vincent Hospital, Indianapolis, USA) on “Clinical outcomes of a new epicardial/endocardial ablation procedure (convergent) for the treatment of atrial fibrillation” demonstrated positive outcomes on 60 patients undergoing the Convergent Procedure, considering 88% of patients had persistent or longstanding persistent AF. This was a difficult cohort of patients with enlarged left atria, and an average BMI over 35. At an average follow up of 11 months (333 +/- 156 days), 79% of patients were in sinus rhythm. Notably, this continued to hold true for the 14 patients who reached 18 months follow-up, with 79% remaining in sinus rhythm, all of whom were also off AADs.

The various posters and presentations reaffirmed the ability of the Convergent Procedure to achieve consistent single procedure results across hospital sites. The potential advantage of the Convergent Procedure is that it integrates the best practices of surgeons and electrophysiologists in a single setting, utilising a minimally invasive, trans-diaphragmatic approach for direct access to the posterior of the left atrium without chest incisions, lung deflation, or cardiac dissections. Developed by physicians and enabled by nContact’s epicardial ablation technology, it has been shown to be especially appropriate for AF patients with enlarged atria and persistent or long-standing persistent stages of disease.