What Is Convergent Hybrid AFib Ablation?

Convergent hybrid ablation is an innovative treatment for a type of irregular heart rhythm called atrial fibrillation (AFib). The treatment is a two-stage procedure that combines the expertise of our electrophysiologists (experts in the heart’s electrical system) and heart surgeons.

The convergent procedure is one of the least invasive, most successful methods for surgically treating AFib that doesn’t improve with other treatments. Patients experience less pain and recover more quickly with the convergent approach than with other surgical options.

Man holding chest in pain

Who Is a Candidate for the Convergent Procedure?

Convergent hybrid ablation is only appropriate for patients who have:

  • long-lasting, persistent AFib that causes symptoms;
  • previous AFib treatments that were unsuccessful;
  • intolerance to AFib medications; or
  • heart failure with AFib.

Convergent ablation isn’t for people who:

  • have had a blood clot in their left atrial appendage,
  • had previous heart surgery, or
  • can’t take blood thinners.

What to Expect During Surgery

The convergent procedure for AFib happens in two stages: minimally invasive surgical ablation and left atrial appendage closure and catheter ablation.

Surgical Ablation

During the first stage of convergent hybrid ablation, your surgeon creates a pattern of small scars in your heart’s tissue to redirect electrical signals. During this first stage, your surgeon will:

  • make a small incision near the end of your breastbone, and
  • create a pattern of small cuts in the upper left part of your heart,
  • make three small incisions (each about 0.5 to 1 centimeter long) on the left side of your chest, and
  • place a device called an AtriClip using a camera.

The AtriClip closes a part of your heart called the left atrial appendage. We do this to reduce the risk of blood clots forming in your heart. A left atrial appendage closure is crucial for lowering your risk of stroke.

A small drainage tube remains attached to the outer left side of your chest. It stays in place for about 24 to 48 hours while you recover in the hospital.

Catheter Ablation

About one to two months after the surgical ablation, our electrophysiologist will perform a catheter ablation to reinforce and extend the scar pattern.

Your electrophysiologist will:

  • insert a long, hollow tube (catheter) through a vein near your groin.
  • push thin IV tubes (sheaths) and needles through the catheter to reach your heart.
  • use a video X-ray (fluoroscopy) to view your heart in real-time.
  • send cold energy (cryoablation) or heat (radiofrequency ablation) to your heart tissue to reinforce and extend the scar lines created by your cardiac surgeon.

How Long Does a Convergent Hybrid Ablation Take?

You are typically in the operating room for around three to four hours during the first stage of convergent hybrid ablation. You will stay in the hospital for 24 to 48 hours after surgery.

The second stage of the procedure typically takes one to two hours. You will return home the same day.

How to Prepare for a Convergent Ablation Procedure

You can usually continue taking regular medications before a convergent hybrid ablation procedure. If you take blood-thinning medicines, your surgeon will likely instruct you to stop taking them the night before the procedure. You’ll also need to stop eating or drinking at midnight on the day of surgery.

You will have a chest computed tomography (CT) scan or echocardiogram immediately before surgery. These imaging tests ensure that you don’t have a blood clot before you go to the operating room.

Why Choose University of Utah Health?

Treating AFib can be complex. At U of U Health, cardiac surgeons and electrophysiologists collaborate closely to offer you the most advanced treatment options, including the convergent hybrid ablation. Our specialists conduct research, publish papers, and test new AFib treatments through clinical trials. Our electrophysiology leaders have contributed to creating national and international guidelines for best practices in AFib treatment. When you come to us, you are choosing physicians with worldwide expertise. We aim to improve your overall quality of life through our comprehensive AFib program.

Senior couple smiles at each other

Convergent Hybrid Ablation Recovery Time

After surgery, you’ll resume or start taking blood-thinning medication. You may have mild chest pain for 24 to 48 hours.

You don’t have to follow any special instructions for restricting movement or caring for your incision. Most people resume their usual activities within a week.

Convergent Hybrid Ablation Risks and Complications

Convergent hybrid ablation has low complication rates. In the first clinical trial for this treatment, fewer than one percent of patients experienced complications.

Some of the risks associated with the convergent hybrid procedure for AFib include:

  • pericarditis, or inflammation in the tissue that surrounds your heart (pericardium), and
  • bleeding around the heart.

Our care team will give you medication to reduce your risk of pericarditis and other complications. Contact us right away if you experience any signs of convergent procedure complications, including:

  • drainage at the incision site,
  • fever, or
  • redness or swelling around the incision site. 

Convergent Hybrid Ablation Success Rate

For patients who are good candidates for the surgery, convergent hybrid ablation procedures have excellent success rates. Convergent hybrid ablation is more effective at keeping patients in a regular heart rhythm than multiple cardiac catheter ablations.

In clinical trials, up to 70 percent of patients still had a regular heart rhythm one year after the procedure. In contrast, only about 40 percent of patients who have multiple cardiac catheter ablations for AFib have a typical heart rhythm one year later.

Make an Appointment with an AFib Specialist

The earlier you receive AFib treatment, the higher your chances of an optimal outcome. You don’t need a referral, but it’s always a good idea to check with your insurance before scheduling an appointment. You may contact us directly call 801-585-7676 for an appointment.

Refer a Patient

If your patient is a good candidate for the convergent procedure, a timely referral is important. Please fill out our physician referral form or call 801-581-2897 to speak with a physician referral specialist.