November 11, 2016
- The latest advancement in treating persistent, long-standing atrial fibrillation was performed for the first time in Utah at Ogden Regional Medical Center
- Pioneering heart specialists continue their collaboration to offer solutions to patients with AFib that has not responded to prior treatment or has resumed
- Convergent ablation brings a solution to Utah patients with the most difficult to treat AFib
Ogden Regional Medical Center and two heart specialists are once again the first in Utah to collaborate in order to help patients with persistent, long-standing atrial fibrillation, often called AFib. This time, the specialists have partnered to offer "Convergent ablation" as an innovative option for patients with the most difficult to treat AFib, the most common form of cardiac arrhythmia.
The latest advancement in treating persistent, long-standing AFib was performed for the first time in Utah at Ogden Regional Medical Center. Cardiovascular surgeon David G. Affleck, M.D. and cardiac electrophysiologist Peter G. Forstall, M. D. are among only a limited number of AFib specialists nationwide who combine their expertise to perform the Convergent ablation. This team approach is improving the lives of patients challenged with AFib that has not responded to prior treatment or has resumed.
"For most patients, AFib is not a benign disease; it significantly increases the risk of stroke and heart-related death," says Mark Adams, CEO at Ogden Regional Medical Center. "That is why I greatly value all that Dr. Affleck and Dr. Forstall are doing to provide advanced treatment options and improve care for our patients. They are establishing a new standard of care for AFib in Utah and surrounding states."
Dr. Affleck and Dr. Forstall were also among the first three specialists in the state to pioneer the innovative hybrid ablation procedure in 2013. That minimally invasive procedure combines a surgical ablation (controlled burns) on the outside of the heart through a chest incision and a catheter ablation on the inside via the femoral vein over the course of a few days during one hospital stay.
While similar, the Convergent ablation procedure differs in two ways:
- The surgical cardiac ablation is performed via small incisions in the abdomen laparoscopically - eliminating the need to deflate a lung.
- Both ablations are completed during one anesthesia session in a single day, which significantly reduces the time patients are hospitalized.
The minimally invasive Convergent ablation procedure is now available at two MountainStar hospitals:
- Cardiovascular surgeon Dr. Affleck and cardiac electrophysiologist Dr. Forstall performed the procedure for the first time on Aug. 21, 2016 in Utah at Ogden Regional Medical Center
- Dr. Affleck and cardiac electrophysiologist Dr. Eifling began offering the procedure to patients at St. Mark's Hospital in September 2016
When it comes to treating AFib, specialists must weigh the invasiveness of the treatment against its efficacy and select the best option for each patient. Given that the effective combined Convergent ablation does not involve cardiopulmonary bypass, lung deflation or chest incision, it is the most minimally invasive, effective treatment available today for patients who are good candidates for this approach.
Convergent Ablation: Patient Benefits
Provides a treatment option for patients who fit the following criteria:
Chronic, continuous or difficult to treat atrial fibrillation
Other AFib treatments and ablations have not been successful
Cannot undergo hybrid ablation due to lung disease or other medical conditions
- Integrated patient care provided by AFib specialists with complimentary expertise
- Faster and less invasive option; external and internal ablations performed sequentially during one general anesthesia session
- Combined approach reduces overall procedure times
- Decreased stay in the hospital and quick recovery
How It Works
The Convergent approach combines external ablation of the back wall of the heart with internal ablation of the pulmonary veins using the most advanced technologies available. The cardiovascular surgeon and the cardiac electrophysiologist work as a team during one procedure to perform the ablations on a beating heart.
- The surgeon makes three small (0.5-1 inch) incisions in the abdomen under the ribcage and inserts an endoscope through the diaphragm that provides a clear view of the outside of the heart
- Via the endoscope and a surgical ablation tool, the surgeon places a series of ablations (controlled burns) in specific locations on the outside surface of the heart
- The cardiac electrophysiologist then threads a catheter through the femoral vein in the groin to the inside of the heart and fills in gaps with more burns in areas that the surgeon cannot reach on the outside surface.
- The combined series of connected burns more effectively creates solid lesions (scar tissue) that block the storm of chaotic electrical signals that cause AFib.
- Ablation completeness ensures substantially better outcomes for patients with persistent AFib.
- Before the procedure is completed, the EP conducts additional tests to confirm that the abnormal signals have been eliminated and regular heart rhythm is restored.
While Convergent ablation is a new option in Utah and other states, it has been conducted approximately 2,000 times worldwide. Success rates for the combined Convergent ablation procedure are better than for less invasive options.