Sometimes a racing heart is a good thing, like when you’re trying something new or tackling a workout. But in the case of those with atrial fibrillation (AFib)—a serious heartbeat irregularity that affects nearly one in 10 people over age 65—it can be a sign of trouble. While some people with AFib hardly notice the condition, others face daily heart palpitations, extreme fatigue, chest pressure, and shortness of breath. In either case, potential long-term complications can occur (according to the American Heart Association, AFib patients are five times more likely to suffer a stroke than those without the condition).
In 2017, Roper Hospital became the only facility in the Lowcountry to offer Convergent, a hybrid procedure for AFib that helps restore the heart’s rhythm by operating both outside of and inside the heart. Here, Roper St. Francis Healthcare affiliated cardiac surgeon Dr. Scott Ross explains how Convergent works, and how it can improve outcomes for people with previously hard-to-treat cases of the chronic condition.
What exactly happens in patients with AFib and why is it so dangerous?
SR: With AFib, the two upper chambers of the heart (called the atria) receive irregular electrical signals, causing them to beat erratically and more quickly than usual. A normal heart beats anywhere from 60 to 100 times per minute; AFib patients’ hearts can experience up to 175 beats per minute. When the heart beats irregularly, it can cause blood to clot in the upper chambers, potentially leading to stroke or heart failure, as well as a host of uncomfortable day-to-day symptoms.
Who is most commonly affected?
SR: Advanced age is the greatest risk factor, but others include obesity, diabetes, and high blood pressure. AFib currently affects between three and six million Americans; as the population ages, that number will grow.
How is AFib treated?
SR: Many AFib patients take medication to control their heart rhythm and blood thinners to reduce their chance of stroke. If those don’t help manage the condition, another option is ablation, which involves burning or freezing a portion of heart tissue to destroy the irregular electrical pathways. Traditionally, ablation is performed through minimally invasive surgery or on the inside of the heart via a catheter. Convergent combines the benefits of both approaches.
How does Convergent work?
SR: The whole procedure is performed under camera guidance. First, a cardiac surgeon performs ablations on the outside of the heart through a small two-inch incision at the base of the chest. Next, an electrophysiology cardiologist inserts a catheter through the groin and performs ablations on the inside of the heart. The procedure takes about four hours and is followed by one to three days of in-hospital recovery time. While Convergent requires general anesthesia, it is not a traditional open heart surgery, so the risks of bleeding and infection are relatively low.
Who is benefiting most from this procedure?
SR: Convergent is a great option for patients who have had difficulty managing their AFib in the past, whether because they developed an intolerance for medication or had unsuccessful catheter ablations. We’ve seen excellent results from Convergent thus far, and patients have reported a huge improvement in the burden of their symptoms. Thanks to this procedure, we are now able to offer a full range of treatment options to those with AFib.