Well over 2.5 million adults in the United States have atrial fibrillation (AFib), according to the American Heart Association. Although it is the most common type of heart arrythmia (irregular heartbeat) disorder, it still presents potential danger.
“A-fib is a big problem and can be very debilitating for some patients,” says Philip Bongiorno, M.D., a cardiothoracic surgeon at Cleveland Clinic Weston Hospital. Left untreated, AFib can cause blood clots and stroke.
For people with AFib who have not had success with medication or previous ablation treatments, a new approach called the Convergent procedure is now available and offered at Weston Hospital. A collaborative effort between a cardiac surgeon and an electrophysiologist, Convergent is a minimally invasive two-step treatment. In the first step of the process, the patient undergoes ablation to the outside of the heart through a procedure involving two small incisions in the chest area. Ablation uses heat or extreme cold to destroy small areas of the heart tissue and create scarring that helps get a patient’s heart back into normal rhythm.
At the same time, patients receive the added benefit of having the left atrial appendage removed. This appendage is the part of the atrium that collects blood clots and is thought to be the cause of most strokes related to AFib.
“Removing the left atrial appendage is essentially a ticket for patients to come off blood thinners,” Dr. Bongiorno says. “The biggest problem with AFib is strokes, and the blood thinning used to prevent strokes leads to bleeding. Some patients can’t even tolerate blood thinners, so this is a good solution for them.”
In the second procedure, which takes place between two and six weeks later, ablation is done to the inside of the heart. This also utilizes a minimally invasive approach in which access to the heart is obtained through a catheter inserted through the groin.
Both procedures require an overnight hospital stay and patients are back to normal activity in about a week or so.
Treatment is essential for living with AFib. Typical first-line treatment is medication aimed to control the heart rate, blood thinners to prevent strokes and, sometimes, medication to get the heart back into a normal rhythm, Dr. Bongiorno says. Ablation procedures are a second line of treatment for patients who have symptoms from AFib or who do not wish to continue medications. Standard ablation procedures are minimally invasive, performed through a catheter and can be done to the inside or outside of the heart.
“We generally offer Convergent to patients with persistent AFib – people who have it maybe a little worse,” Dr. Bongiorno says. “This should be perhaps the last ablation these patients have to have – their last and best ablation.”
To schedule an appointment with Dr. Bongiorno or another cardiothoracic specialist at Cleveland Clinic in Florida, call (954) 659-5320 or visit ClevelandClinicFlorida.org/Heart to learn more.
