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Hybrid procedure helps treat difficult cases of atrial fibrillation

Cardiologists and heart surgeons at Stanford Hospital are using a hybrid technique to address some of the most challenging cases of atrial fibrillation.

A disorder found in about 2.2 million Americans, atrial fibrillation is a result of rogue electrical impulses in the heart’s upper chambers, the atria, disrupting the normal cardiac rhythm. In some cases, patients don't respond to the typical treatments of medication, cardioversion and either catheter or surgical ablation.

But a new procedure using minimally invasive surgery and an intravenous catheter to get to the problem-causing tissue on both sides of the left atrial wall may provide such individuals with some relief. According to a hospital release:

In the past, only select hospitals have offered combined surgical and catheter ablation, breaking it up into two separate operations over the course of about a week. Stanford Hospital, however, is one of the first to do both procedures at once. This means patients do not need to endure two separate preparation and recovery periods. And because the two sets of specialists are in the same room at the same time, they can immediately consult with one another about the specific case - making it easier, for example, for the cardiologist to target the locations needed to complete the ablation.

The surgeons operate first, making fingernail-sized incisions to insert a tiny camera, which guides their work, and a small instrument that delivers cell-destroying energy to tissue on the left atrium’s outside wall. Then cardiac electrophysiologists guide a catheter from the femoral vein into the cavity of the left atrium, where they deliver energy to many of the same sections but from the opposite side.

Stanford is one of a handful of institutions worldwide doing this combination of surgical and catheter ablation at the same time. Research into the new treatment is being supported by a grant from the National Institutes of Health and the School of Medicine.

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