During the recent Atrial Fibrillation Session of the Techno College at the European Association of Cardiac Thoracic Surgeons in Geneva, Switzerland, Professor Borut Gersak, Head of Cardiac Surgery from University Medical Center in Ljubljana, Slovenia challenged his audience of more than 1,000 medical professionals to think differently about existing atrial fibrillation surgical approaches. He called for the cardiac surgeons in attendance to encourage cardiologists to refer atrial fibrillation patients for stand-alone, interdisciplinary hybrid procedures that are significantly less invasive, yet allow for a more complete treatment of the condition and improved results.
Professor Gersak has been instrumental in developing the Convergent Procedure, a completely closed-chest surgical technique that is designed to treat all types of atrial fibrillation, the most common cardiac arrhythmia (abnormal heartbeat) affecting millions of people worldwide.
The Convergent Procedure is a combined epicardial-endocardial ablation approach. A cardiac surgeon initially creates a comprehensive bi-atrial lesion pattern through a 2.5cm abdominal incision, without chest incisions, ports, or lung deflation. The surgeon utilizes the nContact coagulation device during epicardial ablation to create continuous, linear lesions on a beating heart. Within the same setting, an electrophysiologist will then perform endocardial ablation to complete the lesion pattern and utilize mapping and diagnostics to ensure procedure endpoints are achieved.
"Cardiologists don't accept surgical ablation procedures as 'minimally invasive' if they require multiple thoracic incisions and lung deflation. As such, procedures for treating atrial fibrillation must eliminate invasive chest incisions while allowing surgeons to have direct visualization of the heart and their instruments through endoscopes," stated Professor Gersak. "This subthoracic total endoscopic 'subtle' approach to surgery is the key to adoption of the Convergent Procedure, which provides a complete interdisciplinary approach to address the tougher atrial fibrillation patient populations with improved procedure times, less patient discomfort, and quicker recovery."
At the Techno College Session, cardiac surgical leaders echoed the call for improved technologies that enable less invasive surgical approaches and precise diagnostic endpoints to predict results for atrial fibrillation procedures.
Professor Gerhard Wimmer Greinecker, Chief of Cardiac Surgery at the Heart and Vascular Center in Bad Bevensen, Germany, who chaired the atrial fibrillation session, joined Professor Gersak in support of "subtle surgery" for treating atrial fibrillation. "Techniques such as the Convergent Procedure are the future of atrial fibrillation treatment as it leaves the thoracic cavity and lungs undisturbed, while enabling the cardiac surgeon to have visibility and access to the heart. This will be an important advantage in the minds of cardiologists and patients, as the approach is thought of simply as a 'procedure' rather than surgery. Demand for 'subtle surgical approaches' will continue to drive future innovation and adoption within the atrial fibrillation market."