A study published in the Polish Journal of Cardiology has suggested that the minimally invasive hybrid ablation technique, also known as “convergence process” (Convergent Procedure), which combines the technologies of electrophysiologists and surgeons for the treatment of patients with persistent atrial fibrillation is safe and effective. The study showed that in 27 patients after a six-month follow-up phase, 72% remained in normal sinus rhythm without administration of antiarrhythmic drugs. After one year follow-up phase, the figure increased to 80%, and after two years, a small cohort of patients remained completely without arrhythmia (100%). The study was conducted at the University Silesian Center for Heart Disease Medical University of Selisia in Zabrze, Poland.
“These are very impressive results. They indicate treatment success in patients with enlarged atria with limited treatment options,” said Oskar Kowalsi, specialist electrophysiologist and author of the publication, Silesian University’s Center for Heart Diseases, Poland.
In the study, 27 highly symptomatic patients with persistent atrial fibrillation and long-lasting persistent atrial fibrillation who were treated with the convergence process were observed. Persistent atrial fibrillation and long-lasting persistent atrial fibrillation patients have resulted in a 90% share of the total population of patients with atrial fibrillation. However, this showed that individual catheter and surgical stand-alone treatments yield satisfactory results, have a high rate of recurrence and require repeated interventions in the recovery process.
“The main advantage of the convergence process is because of its multidisciplinary approach that provides a more comprehensive and complete treatment of atrial fibrillation,” said Michal Zembal, surgeon, University Silesian Center for Heart Disease, Poland. “Electrophysiologists and surgeons collaborate very effectively to achieve good results. Therefore, we are confident that we can treat lesions more effectively and optimise insulation. In this way we were able to prevent weaker positive results, which can be observed with traditional methods over time.”
“The surgical portion of the combined procedure is reduced to a minimum. No other modern method as minimally invasive.The method is based on a novel trans-diaphragm method, which only makes a 2cm long abdominal incision required to gain access to the heart and puts the surgeon in the position to make lesions in the atrium and connect,” Zembal added.
The convergence method comprises of ablation of the outer side of the heart by a surgeon and the ablation carried out by an electrophysiologist within the heart. “This leaves gaps in the surgical ablation that are impossible to achieve outside of the heart,” said Kowalski. “The electrophysiological mapping and diagnostic apparatus permits the detection of gaps and the location of surgical lesions in thicker tissue and ensure electrical isolation of specific areas of the heart. Therefore, I spend more time in diagnosis and the application of technology to ensure the completion of the process and to ensure success. For this patient population, the combination of the two disciplines has produced better results than the traditional use of individual methods.”
The Silesian Center for Heart Disease is the only institution in Poland that can offer this procedure.
“After a series of presentations and studies that prove the effectiveness and benefits of the procedure, the convergence process is now used more and more frequently,” said Marian Zembala, director of the University’s Center for Heart Disease, Poland.