Chapel Hill, N.C. — In patients with atrial fibrillation, the upper chambers of the heart beat out of rhythm.
With difficult to treat cases, patients chose between two solutions: scarring the heart from inside with an ablation catheter or doing the same thing on the outside in open-heart surgery.
Both procedures offer a 50 to 70 percent chance of success.
Dr. Andy Kiser, a cardio-thoracic surgeon at UNC Hospitals, pioneered the convergent procedure, a new minimally invasive method that uses both approaches at the same time. It offers 80 to 90 percent success rates.
“This is a great example of teamwork to have the cardiac surgeon working side by side with the cardiologist,” Kiser said.
“When we work together, the patient gets the best of both worlds,” UNC cardiologist Dr. Paul Mounsey said.
Kiser brought the convergent procedure to UNC, which is also offered at Duke University Medical Center.
Instead of opening the chest, Kiser approaches the heart laparoscopically just below the breast bone.
“Through that hole, I can then put the camera into the sac that's around the heart and operate on the heart while it's still beating,” Kiser said.
Heating elements scar the heart to redirect electrical impulses. Then, Mounsey takes over, reaching the inside of the heart with an ablation catheter. A 3-D model helps him map areas that need scarring.
Many patients achieve normal heart rhythm during surgery, while most others achieve it soon after, giving them a new chance for a normal life.
About 60 convergent procedures have been performed in North Carolina.
Kiser travels the country to teach other teams of cardiologists and cardiac surgeons how to do the procedure.