(continued from page 10)
PHOTOS BY JIM SHAW
“Electrophysiologic evaluation and intra-cardiac mapping at the time of the procedure demonstrate the effectiveness of the Convergent Procedure,” says Dr. Landers. “This allows for less procedural time and less fluoroscopy (radiation) exposure during the catheter ablation portion of the procedure. The Convergent Procedure reduces the overall operative time, avoids chest incisions and lung deflation, and uses only three miniature abdominal incisions, in addition to the access for the catheter ablation. For the patient, it means less pain, shorter hospital stays and greater overall chance for success.”
Surgical Team (bottom row, left to right) - Kelly Garner, R.N., Kathy Coon, R.N. and Tammy Horne, R.N. (top row, left to right) - Bill Cockfield, P.A. and Neal Murty, S.T.
one or more attempts at catheter ablation or are not candidates for catheter ablation.” Left atrial size and AF duration are important factors in this decision process. When the left atrium is larger than 6.0 centimeters or the duration of AF is greater than five years, the long-term success for the “cut-and-sew” maze procedure is under 80 percent. It is difficult for the electrophysiologist to consistently and effectively complete PVI when the left atrium is greater than 5.0 centimeters. Therefore, when a patient has paroxysmal AF and the left atrium is under 5.0 centimeters, percutaneous catheter ablation is considered. In this population, simple PVI—with or without additional ablation lesions—may be effective in more than 80 percent of patients. Patients with paroxysmal AF and a left atrium greater than 5.0 centimeters, and/or those with persistent, longstanding AF demonstrate the best outcomes when a bi-atrial lesion pattern is created. Surgeons who have experience with minimally invasive approaches choose the ablation technology best suited for their technique. Whichever approach and device is used, a comprehensive lesion pattern of contiguous and transmural lesions are essential. Persistence and intra-operative verification of lesion and pattern integrity is crucial. CONVERGENT TEAM Dr. Andy C. Kiser, M.D., FACS, FACC, FCCP, is board certified in cardiac and thoracic surgery. He earned his medical degree from the University of North Carolina at Chapel Hill, where he also completed his internship, residency and fellowship. Dr. Mark D. Landers, M.D., FACC, is a board-certified cardiologist and electrophysiologist with Pinehurst Cardiology Consultants L.L.P. He earned his medical degree from Eastern Virginia Medical School, and completed his internship and residency at the University of Connecticut. His cardiology and electrophysiology fellowship was completed at the University of Colorado.
EP Team (bottom row, left to right) - Lisa Tully, R.N., Christy Marley, R.N. and Joan Burge, R.N. (top row, left to right) - Nancy Carter, R.N., Randy Williams, CVT and Todd Laws, CVT
Outcomes “are fantastic,” the doctors say. The most recent 12-month data show a success rate of about 90 percent freedom from AF. An abstract of the Convergent Procedure summarizing the first 15 months of performing the Convergent Procedure was presented at the Heart Rhythm Society meeting in May.
Dr. Ker Boyce, M.D., FACC, is a board-certified cardiologist and electrophysiologist with Pinehurst Medical Clinic Inc. He earned his medical degree from Emory University School of Medicine in Georgia. He performed his internship and residency at Emory University Affiliated Hospitals. His cardiology and electrophysiology fellowship was completed at the Naval Medical Center in San Diego, Calif., and the University of California San Diego Medical Center.
CONVERGENT CANDIDATES Today, the FirstHealth Arrhythmia Center offers comprehensive treatment for patients with atrial fibrillation, and is recognized nationally and internationally for the Convergent Procedure for treatment.
For more information about the Convergent Procedure, call (910) 715-1713 or toll-free (800) 213-3284, or visit www.convergentprocedure.com.
The consensus opinion by the Heart Rhythm Society Task Force states that “standalone AF surgery should be considered for symptomatic AF patients who prefer a surgical approach and have failed 12
The Triangle Physician | JUNE 2010
Drs. Andy Kiser and Mark Landers regularly present “Treatment Options for Atrial Fibrillation” to help unravel the complexities of this troublesome condition. The information sessions are free and open to the public. The next one is set for July 20, from 5:30 to 7 p.m., at the Moore Regional Hospital conference center. To register, call (910) 715-1478 or toll-free at (800) 213-3284.