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AFib Institute Cardiac Electrophysiologist along with Cardiac Surgeon debuts new Convergent Ablation procedure for patients with persistent Atrial Fibrillation

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QCG Atrial Fibrillation Institute Cardiac Electrophysiologist Dr Tomos Walters has successfully debuted a new heart procedure for Queensland patients with persistent Atrial Fibrillation. 

The procedure, known as the ‘Convergent Ablation Procedure’ involves a two-stage combination of surgical and catheter ablation treatments, and is specifically for people with persistent or long-standing Atrial Fibrillation. Up until now, this is a group that may have had significant symptoms impacting on their quality of life, or significant impact on their heart function – and there was little that was available to help.  

Dr Walters said the new technique aimed to improve quality of life, minimise stroke risk, protect heart function and suppress atrial fibrillation in challenging AFib patients. 

“With the Convergent Ablation procedure we have something to offer these patients with long-standing atrial fibrillation. It’s opened up a cohort of patients who can benefit from advanced rhythm control and we’re really excited about that,” Dr Walters said.  

“The new procedure brings together the surgical side with the electrophysiological side, approaching this challenging patient group with a hybrid approach that opens up the concept of ablation to patients who otherwise would have missed out,” Dr Walters said. 

The new procedure is called the ‘Convergent procedure,’ because it combines two cardiac treatments.

The procedure is a convergence or hybrid of treatment techniques which complement each other to provide a more effective outcome for AFib patients. It is performed on the patient in two phases, involving a multidisciplined team that includes both a cardiothoracic surgeon and a cardiac electrophysiologist working together. The cardiac electrophysiologist is working from the inside tissue of the heart, whereas the surgeon is approaching from outside of the heart. 

As Dr Walters explains, “In this new procedure we are not doing anything radically different in the catheter ablation, the key difference and what makes it more effective for long-standing atrial fibrillation, is the combination of the surgical procedure and catheter procedure, and there is good evidence to support this.” 

During the first phase, the cardiothoracic surgeon inserts a catheter through a small incision on the chest to access the back wall of the left atrium of the heart. The surgeon then ablates this area. During the procedure, the surgeon also performs a left atrial appendage closure using a device called an Atriclip. This appendage closure is an important step to reduce risk of clots forming in the heart which can lead to stroke.  

The second phase, a cardiac catheter ablation is performed by a cardiac electrophysiologist (an EP). A cardiac ablation uses heat or cold energy delivered to the heart tissue through a catheter fed up to the heart from the leg. The ablation is on the inside of the heart wall, usually around the pulmonary veins.  

The two steps in the Convergent procedure are performed over a period of a few months.

Dr Walters explained that most cardiac centres in the US and Europe are performing the two phases of the Convergent Ablation procedure over a period of a few months. 

“The AFib patients first have a short admission under a surgeon for their minimally invasive surgical procedure. They then go home hopefully in a normal sinus rhythm. Once we allow everything to heal, they come back three months later for the catheter ablation procedure,” he said. 

The evidence-based new procedure has had great success overseas, and in Western Australia, and is now available for the first time on the Australian East coast.

The Convergent Ablation procedure, has been successfully performed in cardiac centres overseas, and in Western Australia. For the first time, it is now available on Australia’s east coast, through St Andrew’s Hospital and partnership between Cardiac Electrophysiologist Dr Tomos Walters and Cardiothoracic Surgeon Dr Rishendran Naidoo.  

“There is one centre in Perth that’s been doing it for the last three years – they’ve treated 100 patients now with very good results and very low rates of complications. 

“We are proud at QCG’s AFib Institute to be involved in the first site to set this procedure up on the east coast of Australia.”   

The Convergent Ablation procedure is available now to new and existing QCG AFib Institute patients across Queensland.

The Convergent Ablation procedure is appropriate for patients with long-standing persistent atrial fibrillation, who have either persistent symptoms or who have impact on their heart function or signs of heart failure. Often in this challenging group of patients, they have had AFib for so long that the standard catheter ablation-based approaches were no longer effective enough.  

Dr Walters said “In patients with what we call long standing persistent AF who’ve been in AF for a long time, targeting both the outside and the inside of the heart increases the effectiveness of the procedure. Doing a hybrid procedure where the surgeon tackles it from the outside and then three months later a cardiac electrophysiologist completes the process from the inside has been clearly demonstrated to be both more effective and safer.” 

Dr Walters and the team at the QCG AFib Institute hope over time that this procedure becomes more visible, and GPs will be able to refer AFib patients directly to the procedure. Patients with persistent or long-standing AFib are encouraged to discuss this new treatment option with their GP, or ask for a referral to the Atrial Fibrillation Institute.  

If you would like to talk with one of the Cardiac Electrophysiologists at the AFib Institute, you can book an appointment at one of our South East Queensland locations within the Queensland Cardiovascular Group (QCG). 

You can contact us via phone:  07 3016 1111 or via our online inquiry form here. 

You will need a referral from your doctor. 

Our doctors also perform cardiac surgeries and procedures at Private Hospitals throughout Queensland including St Andrew’s War Memorial Hospital, Greenslopes Hospital, Mater Private Hospital, and St Vincent’s Hospital Northside.