If your heart rhythm is disturbed, that is, Atrial Fibrillation (Afib), a heart rhythm disorder, persists despite taking medication and other treatments, you may also feel that there is no permanent solution to this? Sometimes this condition may also make you feel very worried. But don't worry, with the advancement of medical science, there are now very effective treatments for such conditions. It is precisely for such people that we are talking about this new treatment method today.
What is this Convergent Procedure?
Simply put, this is a combination of two treatments. That is, a small incision surgery and a treatment called catheter ablation . We also call this a hybrid treatment.
Think about it, our heart has an electrical signal system. This is what keeps the heart beating properly. In Afib, these signals get messed up, and the upper chambers (atria) of the heart send out erratic, fast signals. In the convergent procedure, surgeons and cardiologists work together to make very small incisions inside and outside your heart where these erratic signals are coming from. These incisions stop the erratic electrical signals from traveling. It's like closing off the wrong road and sending the cars back on the right road.
Who is this treatment most suitable for?
This treatment is not for everyone. It is especially recommended for:
- For those with persistent Afib .
- For those who have recurrent Afib episodes despite taking medication and undergoing standard catheter ablation treatment.
If you have a similar condition, you can talk to your doctor to decide if this treatment is right for you.
How do you prepare before surgery?
Like any surgery, there is a little preparation involved.
- Blood thinners (anticoagulants): If you are taking these medications, you will need to stop them a few days before surgery. Your doctor will tell you exactly how many days in advance and which medications to stop. Never stop taking your medications without your doctor's advice.
- Fasting: Before surgery, you will be asked to stop eating and drinking for a specific period of time (fasting). Your doctor will also inform you about this period.
Sometimes both parts of this treatment are done on the same day. Sometimes they are done about four weeks apart. Your medical team will explain this to you.
How is the surgery performed?
This treatment consists of two main parts. Let's take a look at what happens in each part.
| Part of the treatment | What happens is simple. |
|---|---|
| Part One: Surgery (Treatment of the Heart from Outside) | After you are fully anesthetized, a cardiac surgeon makes a very small incision, about 3-4 centimeters below your breastbone (sternum). Then, the thin membrane around the heart (pericardium) is cut and a camera (endoscope) is inserted. Then, a special energy-conducting tube (catheter) is used to treat (ablate) the areas on the outside of the heart that are generating abnormal electrical signals. This part takes about an hour and a half. |
| Part Two: Catheter Ablation (Treatment from Inside the Heart) | This part is usually done on a separate day, a few weeks later. Here, a cardiologist (electrophysiologist) inserts a catheter into your heart through a vein in your groin. He or she then treats the inside of your heart , in areas that were difficult to reach during previous surgery. You will be given either light or general anesthesia during this procedure. |
What is Convergent Plus?
Sometimes, at the same time as this surgery, doctors do something else to reduce the risk of stroke. That is, they close off a small part of the left atrium of the heart (the left atrial appendage). When these additional steps are added, we call it a "Convergent Plus" procedure.
What are the benefits of this treatment?
This treatment method has several specific advantages:
- High success rate: This is more successful than the usual catheter ablation treatment because it treats both the inside and outside of the heart.
- Low risk: During this surgery, doctors can clearly see the esophagus, which is located behind the heart. Therefore, the risk of damaging it is very low.
- Not open-heart surgery: This does not require stopping your heart and connecting it to a heart-lung machine (cardiopulmonary bypass).
Are there any risks or complications?
As with any surgery, there are some risks and complications that can occur. However, these are rare in most cases. They include:
- Cough
- Tiredness
- Difficulty breathing
- Stroke
- Bleeding
- Fluid accumulation around the heart (pericardial effusion)
- Nerve damage
- Transient ischemic attack (TIA)
There's no need to worry about this. Your doctor will explain everything to you thoroughly before the surgery.
How long does it take to heal?
After the first part of the surgery, you will need to stay in the hospital for a day or two. If the second part is to be done, it will probably be done in about three months.
You will be scheduled to see your doctor again during your recovery. This is usually 3 weeks after surgery, and then again at 3, 6, and 12 months. At that time, you may be given a small machine (Holter monitor) that is worn on your chest for a few days to monitor your heart rhythm.
When do you want to see the doctor again?
If you experience the following symptoms, inform your doctor immediately.
- If symptoms of Afib (feeling like your heart is beating fast, chest tightness, fatigue) recur.
- If there is bleeding or infection (swelling, redness, pus) at the surgical incision site.
Take-Home Message
- The Convergent Procedure is a highly effective, modern treatment for long-term Atrial Fibrillation (Afib) that is not controlled by medications or conventional treatments.
- This is a combination of surgery and catheter therapy, so it can fix problems both inside and outside the heart.
- The success rate of this treatment is very high, and the recovery time is relatively short.
- The best person to know if this treatment is right for you is your cardiologist. Talk to him or her about this openly and without fear, and make a decision.
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