07:14am Monday 21 October 2019

AGH Heart Specialists Offer Pioneering New Treatment for Atrial Fibrillation

PITTSBURGH, PA   – An innovative procedure offered locally only at the Cardiovascular Institute of Allegheny General Hospital (AGH) is offering new hope to patients with persistent, difficult to treat atrial fibrillation (A-Fib) – the most common heart rhythm disorder.

Currently being performed at just a handful of leading medical centers across the country, the Convergent Procedure combines surgical and electrophysiology techniques in one setting to provide relief for patients with severe cases of A-Fib, including those who suffer from structural heart disease and those who have not benefited from other A-Fib treatments, such as catheter ablation and/or medication.
“The Convergent Procedure allows us to offer select patients a very effective treatment option with a quick recovery time and less pain than conventional surgical procedures,” said AGH electrophysiologist William Belden, MD, “It combines the highly skilled disciplines of cardiac surgery and electrophysiology to help patients get back to their normal lives as quickly as possible.”
A leading cause of stroke, A-fib is characterized by a fast, irregular heartbeat caused by rapid, disrupted electrical impulses in the heart.  When the heart’s electrical impulses are irregular, the heart cannot pump enough blood to meet the body’s needs, and patients may experience symptoms such as shortness of breath, chest palpitations and feeling faint.   Simple tasks can become exhausting.
Because patients often have underlying heart disease, A-Fib can be difficult to treat, Dr. Belden said.
Medications commonly used to treat A-fib may have significant side effects and not all treatments work for all patients. Conventional surgical treatments are technically complex and sometimes require an invasive open chest approach.    Other catheter based treatments, such as radio frequency ablation, are available and effective for many patients, but not all.
“By working collaboratively and sharing our best techniques, we can now provide A-Fib patients with a treatment that is highly effective and helps them avoid common side effects associated with medical treatment,” said AGH cardiothoracic surgeon Robert Moraca, MD, Director of Thoracic, Aortic and Arrhythmia Surgery at AGH.
The Convergent Procedure requires just a small incision in the upper abdomen, similar to that used for laparoscopic gallbladder surgery. The surgeon uses radiofrequency energy to produce a pattern of lesions (scar tissue) on the heart to block the abnormal electrical signals – a technique called ablation. 
After the surgeon completes his portion of the therapy, the electrophysiologist then threads a catheter through the patient’s femoral vein (in the groin) to reach the heart and fill in any gaps in the ablation pattern and confirm that abnormal electrical signals have been interrupted.
“The heart continues to beat during the procedure and readings from the catheters allow us to identify areas of the heart that surgical ablation did not reach so that we are able to target those areas in real time using the catheter ablation,” Dr. Belden said.
Candidates for the Convergent Procedure include patients who have been living with A-Fib for many years, have structural heart disease such as a an enlarged left atrium and those who have failed other A-Fib treatments.
“Studies show the Convergent Procedure is effective up to 70-80 percent of the time,” Dr. Moraca said. “And most often, we can send our patients home after two or three days with minimal pain as compared to an open-heart procedure.”
The Cardiovascular Institute at Allegheny General Hospital offers patients access to the complete spectrum of leading specialists in general and interventional cardiology, electrophysiology, advanced cardiovascular diagnostic imaging – including cardiovascular MRI, coronary CT and 3-D echocardiography – women’s heart care, heart failure and pulmonary hypertension, heart transplantation and mechanical circulatory support, vascular surgery and wound care, thoracic surgery, heart valve disease and coronary artery bypass surgery.  
AGH is the only Pittsburgh hospital and one of just 10 in the state of Pennsylvania to be recognized by Becker’s Hospital Review, a national online healthcare publication, as one of the country’s “100 Hospitals with Great Heart Programs”.  The hospital also was recently lauded by Thomson Reuters as one of the nation’s Top 50 cardiac programs and is one of the region’s only medical centers to be similarly ranked by U.S. News and World Report.
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