Abstract
The treatment of persistent atrial fibrillation (PSAF) remains a
challenge for electrophysiologists. Nowadays, isolation of the pulmonary
veins (PVI) is a routinely applied, well proven and accepted
intervention. Despite this, some patients are in refractory atrial
fibrillation (AF) even after 2 or more procedures. Others are unable to
receive another catheter ablation due to previous cardiac interventions.
The Convergent procedure might be a good option for this type of
patients. Here we report on two of these cases from our clinic: one of a
female patient who underwent a TAVI procedure in our institution 3
months before the epicardial Ablation and the second old male patient
with paroxysmal AF who underwent percutaneous transcatheter closure of
patent foramen ovale (PFO) in 2015 after having an embolic stroke. These
two cases show that the staged Convergent procedure can be performed
safely and with good results even in patient who underwent previous
cardiac interventions. In addition, it might be a good alternative in
patients in whom a primary transcatheter ablation is impossible due to
previous pathologies and interventions.