SJH Heart Institute Becomes Training Center for Convergent Procedure


 As Andrew Sherman, M.D., performs his part of a Convergent procedure, Kevin Makati, M.D., center, explains the process to David B. Delurgio, M.D., director of Electrophysiology at Emory University.

St. Joseph’s Hospital’s Heart Institute’s Advanced Center for Atrial Fibrillation (Afib) continues to achieve acclaim for the innovative procedures that are performed here. It was one of the first hospitals to set up a fully functional atrial fibrillation center of excellence for patient centric care. It also was the first in the country to successfully treat atrial fibrillation with cryoablation and is the busiest in the world for that procedure. Now nContact Surgical, Inc., has chosen the SJH Heart Institute as the first training center in Florida for the Convergent Hybrid method of treating persistent atrial fibrillation.

“To be chosen as a training site confirms that our staff is proficient with the procedure and that we’ve had good results with it,” said Pam D’Amore, administrative director of the Heart Institute. “It just adds to our Afib program.”

“Persistent atrial fibrillation is a ubiquitous and complex disease requiring the greatest expertise and the most sophisticated techniques,” said electrophysiologist Kevin Makati, M.D. “Afib is a complex electrical disorder of the heart and it is difficult to treat. We have finally found something that is truly noninvasive and, not only effective, but has minimal downtime for the patient.”

Cardiac surgeon Andrew Sherman, M.D., concurs. “The Convergent method is one of the few procedures from a surgical standpoint that I’ve seen for Afib that truly satisfies what I think are the requirements of a minimally invasive procedure: it is very safe and has minimal discomfort to the patient; the patient has a very short hospital stay; and patients are able to gain their full activity for whatever they want to do in life very quickly after this procedure.”

Drs. Makati and Sherman developed the Heart Institute’s Convergent program in 2012, merging their two specialties with the cryoballoon technique. James Irwin, M.D., has now joined them in offering this innovative procedure to his patients as well. “There are less than 10 centers in the world that do this combination,” Dr. Makati said.

The Convergent procedure is done through two or three port type incisions in the abdomen similar to how patients have their gallbladders taken out minimally invasively. Through that approach, Dr. Sherman is able to access the area behind the heart in order to identify and ablate areas of the heart muscle that contribute to Afib; and through the groin, Dr. Makati is able to put small catheters and essentially patch up areas that Dr. Sherman was not able to get to. Together, the Institute has performed more than 70 procedures. Drs. Makati and Sherman are now training other physicians from around the continental US in the Convergent method.

“Our new Heart Institute has allowed us to have an incredible amount of collaboration between our cardiology colleagues,” Dr. Sherman said. “And that’s exactly what you want if you’re a patient who is dealing with any aspect of heart disease. You don’t want each individual specialty thinking about what they want to do with you, you want specialties collectively coming up with a plan that is a safe plan for you as a patient, that has efficacy for you as a patient and that gets you out of the hospital as quick as possible.”

“We’re talking about one preparation, one anesthetic, and when they finish that procedure, there are no further procedures that they need to undergo with their first attempt at maintaining normal rhythm,” Dr. Sherman added.

Dr. Makati and Dr. Sherman attended an expert consensus meeting in Atlanta on October 25, where they presented their experience to physicians who gathered to share best practices. Other colleagues from around the country have visited St. Joseph’s Heart Institute to watch the Convergent procedure in person.

“The expansion of the Heart Institute allowed us to design this superb state-of-the-art Hybrid Operating Room where we can treat the same patient under the same anesthesia,” said Dr. Makati. The hybrid operating room is part of a new expansion to address the growing complexity of heart disease and the need for more innovative techniques that simultaneously provide safer procedures and more efficient delivery of health care. The new 35,000-square-foot facility features state-of-the-art imaging equipment, 17 private beds, electro-physiology and catheterization labs and nine surgical procedure rooms, including cardiovascular operation and hybrid integrated digital suites. Dr. Makati is working with BayCare Clinical Outcomes to demonstrate how the procedure might one day establish the standard of care in managing persistent Afib patients. The project is in keeping with BayCare’s core values of validating procedures that help maintain top decile performance in cardiac care.

“We were already recognized as a Center of Excellence,” Dr. Makati said, “But now this is the first time we are recognized as having the expertise to allow people to train from us.”

Reprinted from St. Joseph's Hospital Chat News, November 14, 2014

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