Embracing New Approaches in Long-Standing Persistent Atrial Fibrillation

Published: 04 August 2022

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  • episode_image
    3m 59s
    Part 1 Welcome and Introductions Andrea Russo, Hugh Calkins, David DeLurgio, Rukshen Weerasooriya, Pragnesh Joshi, Emily Kotschet, Adrian Pick
  • episode_image
    12m 32s
    Part 4 Panel Discussion Andrea Russo, Hugh Calkins, Adrian Pick, Emily Kotschet, David DeLurgio, Rukshen Weerasooriya, Pragnesh Joshi
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This on-demand version of the live broadcast aims to highlight the benefits of a hybrid management approach for minimally invasive procedures.

In non-paroxysmal atrial fibrillation (AF), where modification of the atrial arrhythmogenic substrate is required, catheter-based ablation using a transvenous, endocardial approach is commonly used but there is growing evidence for a hybrid approach to improve patient outcomes. Research suggests that an integrated approach involving both electrophysiologists and surgeons can lead to improved success rates and increased patient satisfaction compared with a catheter-only approach.


Whilst relatively new, hybrid AF ablation counts some of the world’s leading surgeons and electrophysiologists amongst its advocates. This expert-led broadcast is aimed at increasing awareness of the approach and helping physicians to adopt it in their daily practice, thanks to a series of practically-focussed presentations and discussions from some of the world’s leading experts.


Note, the live version of this session was CME accredited; this on-demand version is not.

This programme is supported by an unrestricted educational grant from AtriCure.

Key Learning Objectives

  • Define the key team members essential for the adoption of the convergent procedure
  • Recall the scientific evidence supporting the safety and efficacy of hybrid ablation techniques in persistent AF
  • Identify clinical and anatomical features that make patients good candidates for whom the convergent procedure
  • Describe the role of electrophysiologist and surgeon in hybrid approaches
  • Compare the overall approach to hybrid ablation with other approaches such as Mini Maze
  • Identify local barriers preventing the uptake of hybrid ablation approaches

Target Audience

  • Electrophysiologists (EPs)
  • Cardiothoracic Surgeons
  • Interventional and General Cardiologists
  • Other referrers to EPs

More from this programme

Part 1

Welcome and Introductions

Dr Calkins and Dr Russo introduce the faculty and the agenda for the programme.

Part 2

Catheter, Surgical, and Hybrid AF Ablation: How Did We Get Here?

In this first session, Dr Calkins presents on the journey to treat hybrid ablation effectively using different techniques.

Part 3

The Data Behind Hybrid Ablation

Dr DeLurgio provides an overview of the data from the CONVERGE trial.

Part 4

Panel Discussion

The panel wrap up the first part of this broadcast and discuss patient selection for hybrid ablation and practical considerations when adopting a hybrid ablation approach.

Part 5

Adopting a Hybrid Approach

Prof Weerasooriya and Mr Joshi share their experience with case based examples from their practice in Perth, and discuss practical considerations for adopting the convergent procedure.

Part 6

Minimally Invasive Approaches for Long-Standing Persistent Atrial Fibrillation: Building a Successful Practice

In this final session, Dr Kotschet and Mr Pick share their experience from Melbourne. They discuss patient selection and how to build a successful team from an EPs perspective.

Part 7

The Future of Hybrid Surgical Ablation: Panel Discussion

The panel wrap up by discussing audience poll results and the future of hybrid surgical ablation.

Faculty Biographies

Rukshen Weerasooriya

Rukshen Weerasooriya

Clinical Professor of Medicine

Prof Rukshen Weerasooriya is a UWA graduate who completed cardiology training at Royal Perth Hospital.

Prof Weerasooriya commenced private atrial fibrillation ablation procedures in 2003 after returning from 2 years training overseas at the world’s leading centre for AF ablation – the Hopital Cardiologique du Haut Leveque in Bordeaux, France. AF ablation was pioneered and subsequently developed for mainstream application by the cardiac electrophysiologists in Bordeaux.

Prof Weerasooriya is a Clinical Professor of Medicine at UWA and has maintained close links with his alma mater and he maintains a position as visiting scientist at the LIRYC Institute of advanced cardiac arrhythmia mapping in Bordeaux. He has sub-speciality trained in all aspects of heart rhythm management, and in addition to performing catheter ablation…

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Pragnesh  Joshi

Pragnesh Joshi

Cardiothoracic Surgeon

Mr Pragnesh Joshi is a Specialist Cardiothoracic Surgeon. He specialises in all types of heart surgery with special interest in beating heart surgery and minimally invasive heart and lung surgeries.

Mr Joshi is a Fellow of Royal Australasian College of Surgeons. He has had vast experienced as a surgeon for Beating heart bypass surgery and he is also proficient in all types of heart and lung surgeries.   

He is Supervisor of surgical education and training, Adjunct Associate Professor, University of Notre Dame, and Clinical Lecturer, University of Western Australia.

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