Embracing New Approaches in Long-Standing Persistent Atrial Fibrillation











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This broadcast aims to highlight the benefits of a hybrid management approach for minimally invasive procedures. Designed specifically for EPs, cardiothoracic surgeons, interventional and general cardiologists, you will learn about:

  • The history of minimally invasive procedures.
  • Real-world experiences from real-life examples. 
  • The current data that supports the growing evidence for a hybrid approach. 
  • The practical considerations to enable you to successfully deliver a hybrid approach in your centre


Do you know how to deliver a hybrid management strategy to treat patients with non-paroxysmal AF?

What are the practical considerations when adopting a hybrid ablation approach in your centre?

When should the surgeon call the electrophysiologist when treating non-paroxysmal AF - and do they need to?

Learn the answer to these questions and more in this broadcast moderated by Dr Hugh Calkins (Johns Hopkins, US) and Dr Andrea Russo (Cooper University Hospital, NJ, US).

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.


This broadcast has been supported by an unrestricted educational grant from AtriCure.

This programme has been accredited by the European Board for Accreditation of Continuing Education for Health Professionals (EBAC) for 1 CME point, equating to 1 hour of learning. Physicians may convert EBAC External CME credits to AMA PRA Category 1 Credits™.

Performed By:

David DeLurgio

David DeLurgio

Pragnesh Joshi

Pragnesh Joshi

Emily Kotschet

Emily Kotschet

Adrian Pick

Adrian Pick

Rukshen Weerasooriya

Rukshen Weerasooriya

Moderated By:

Hugh Calkins

Hugh Calkins

Andrea Russo

Andrea Russo


19:00 - 19:05 AEST

Welcome and Introductions - Professor Hugh Calkins and Professor Andrea Russo

19:05 - 19:15 AEST

Catheter, Surgical, and Hybrid AF Ablation: How Did We Get Here? - Professor Hugh Calkins

19:15 - 19:25 AEST

The Data Behind Hybrid Ablation - Dr David DeLurgio

19:25 - 19:40 AEST

Live Panel Discussion

19:40 - 19:55 AEST

Adopting a Hybrid Approach - Professor Rukshen Weerasooriya and Mr Pragnesh Joshi

19:55 - 20:10 AEST

Minimally invasive approaches for long-standing persistent atrial fibrillation: Building a successful practice - Mr Adrian Pick and Dr Emily Kotschet

20:10 - 20:30 AEST

The Future of Hybrid Surgical Ablation: Panel Discussion

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

Whilst this session is primarily targeted towards the Australian and Asia Pacific Regions the broadcast is relevant for the global cardiology community, including:

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

Faculty Biographies

David DeLurgio

David DeLurgio

An industry leader in complex Electrophysiology cases and research, Dr DeLurgio uses the most advanced technology to detect, diagnose and treat arrhythmias. While some patients can be treated through the use of medication or even pacemakers, DeLurgio also offers treatment through a procedure called a cardiac ablation. During this safe, minimally invasive procedure, DeLurgio uses high tech 3D images that provide an advanced map of the heart. He is also focused on the development of new cardiac ablation techniques and emerging therapies for the cure of atrial fibrillation.

DeLurgio also focuses on stroke prevention in atrial fibrillation patients by using the innovative non-surgical LARIAT procedure. During the LARIAT, two catheters are guided into a patient’s heart to seal the left atrial appendage (LAA ) with a pre-tied suture loop, which is similar to a lasso. The LAA is the primary source of blood clots leading to stroke. DeLurgio is a leader in the state of Georgia for completing the most LARIAT procedures, which have been shown to decrease a patient’s risk of stroke. DeLurgio’s research is concentrated on the development and testing of cardiac stimulation devices for the treatment of congestive heart failure and the prevention of sudden cardiac death, as well as treatment of complex arrhythmias with novel ablation techniques.

DeLurgio earned his degree from the University of California Los Angeles School of Medicine, and completed his residency at the Emory University School of Medicine. He joined Emory Healthcare in 1996 and served as the director of the Arrhythmia Center and Electrophysiology Lab at Emory University Hospital Midtown before relocating to Emory Saint Joseph’s Hospital.

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Pragnesh Joshi

Pragnesh Joshi

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. He is a fellow of The Royal Australasian College of Surgeons, Australia. 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.   

His main interests are:

  • Minimally invasive sternal sparing aortic and mitral valve surgery
  • Minimally invasive sternal sparing ASD closure, tricuspid valve surgery
  • Minimally invasive thoracoscopic excision of mediastinal tumour, thymus, pleurodesis
  • Beating heart coronary artery bypass surgery
  • Aortic aneurysm and arch surgery.

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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Emily Kotschet

Emily Kotschet

Dr Emily Kotschet is a Cardiologist and Electrophysiologist with a particular interest in inherited cardiac arrhythmias, including cardiac genetics and atrial fibrillation.

She completed her cardiology training at the Alfred and Monash Heart, then completed a three year fellowship in Electrophysiology with 2 years in Canada. She returned to Monash Heart, and established the AF ablation program, including Australia’s first nurse led AF clinic, as well as the cardiac genetics service. She has introduced many new pacemakers and defibrillating devices to Australia, including the Micra leadless pacemaker, and subcutaneous ICDs.

Dr Kotschet works at Holmesglen Private Hospital, Cabrini Hospital in Malvern, Mulgrave Private Hospital and St John of God, Berwick, where she implants devices and performs ablation for arrhythmias. She also provides cardiac services in rural Victoria visiting Alexandra and Morwell.

Emily’s interests include atrial fibrillation management including catheter ablation, device implantation for heart failure (pacemakers, defibrillators and cardiac resynchronisation devices and subcutaneous devices) and inherited arrhythmias such as Long QT syndrome. She has an interest in paediatric electrophysiology, managing children with arrhythmias, and performs ablation in older children. She is happy to consult families and children regarding these conditions.

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Adrian Pick

Adrian Pick

Mr Adrian Pick graduated in 1993, from the Melbourne University Medical School then completed overseas fellowships at the MAYO clinic and the Toronto General Hospital. His interests include minimal access surgery for thoracic and cardiac surgery with emphasis on mitral valve repair and limited access aortic valve replacement. He is also committed to maximizing surgical treatment for both concomitant (often in conjunction with mitral or aortic valve procedures) and lone atrial fibrillation.

More recently he has embraced the transition to Hybrid surgery. He favours the Totally thoracoscopic maze for patients with persistent Atrial fibrillation who have symptoms, have failed catheter ablation or are intolerant to antiarrhythmic drugs or anticoagulants.

Mr Pick works in 5 regional hospitals around Melbourne, has instituted a Cardiac surgical service at Peninsula Private Hospital since 2011 and performs over 500 major Surgical procedures annually. He is a fellow of the Royal Australasian College of Surgeons and a member of EACTS and ISMICS. He presents regularly at local and international meetings and has published widely.

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Rukshen Weerasooriya

Rukshen Weerasooriya

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

Rukshen 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 (www.ihu-liryc.fr). Rukshen has sub-speciality training in all aspects of heart rhythm management, and in addition to performing catheter ablation procedures, the practice is a high-volume implanter of cardiac rhythm devices such as pacemakers and implanted defibrillators.


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Hugh Calkins

Hugh Calkins

Dr Hugh Calkins is Professor of Medicine and Director of Electrophysiology at the Johns Hopkins Medical Institution in Baltimore, USA.  

He has clinical and research interests in the treatment of cardiac arrhythmias with catheter ablation, the role of device therapy for treating ventricular arrhythmias, the evaluation and management of syncope and the study of arrhythmogenic right ventricular dysplasia.

He has certifications from the American Board of Internal Medicine in Cardiovascular Disease (1989), Clinical Cardiac Electrophysiology (1992) and Internal Medicine (1986).2

Dr Calkins has over 38 years of experience in the medical field. He is an Associate Editor of the Journal of Cardiovascular Electrophysiology and is on the editorial board of several prestigious publications including The Journal of the American College of Cardiology; HeartRhythm and Circulation: Arrhythmia and Electrophysiology. He is a former member of the American Board of Internal Medicine Electrophysiology Boards Test Writing Committee. Dr Calkins is a fellow of the American College of Cardiology, the American Heart Association and the Heart Rhythm Society. He led a 44-member international task force whose 2012 Expert Consensus Statement gave recommendations for treatment and research of atrial fibrillation. Dr Calkins is also a past president of the Heart Rhythm Society and was elected to be a member of the Miler Coulsen Academy of Clinical Excellence in 2014.

Over two decades ago Dr Calkins founded the Johns Hopkins ARVC Program, which is the largest and most comprehensive clinical and ARVC research program in the world. He is currently leading several research studies in the field on the topics of the role of exercise in ARVC, assessing the risk of sudden death in patients and the relationship between specific genetic mutations and some clinical features of the disease.

He has published more than 500 articles and book chapters on a wide variety of cardiac arrhythmias. His research has focused predominantly on catheter ablation, atrial fibrillation, syncope and arrhythmogenic right ventricular dysplasia.

Areas of Speciality

  • Adult Congenital Heart Disease
  • Cardiac Electrophysiology
  • Interventional Cardiology
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Andrea Russo

Andrea Russo

Dr Russo is Director of Electrophysiology and Arrhythmia Services at Cooper University Hospital, Director of the CCEP Fellowship program and Professor of Medicine at Cooper Medical School of Rowan University. She has served on numerous HRS committees and task forces and is a member of the Heart Rhythm Journal editorial board. In addition, she has served as co-chair or member on several guideline, consensus document or Appropriate Use Criteria writing groups.

Dr Russo received her medical degree from Upstate Medical Center in Syracuse, New York. She did her residency at the Medical College of Pennsylvania and her fellowship training at the Robert Wood Johnson Medical School at Cooper Hospital. Areas of special interest include sex differences in arrhythmias, implantable cardioverter defibrillators, totally subcutaneous devices, atrial fibrillation therapy, and the role of digital health on arrhythmia management. Dr Russo has been recognized many times as a "Top Doctor" in Philadelphia and Southern New Jersey.

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