I had a consultation with a thoracic surgeon today and we discussed my EP’s recommendation for a convergent/hybrid ablation. I was given quite a bit of information which seems to be generated by the company who manufacture the device used in the ablation; AtriCure. I have read so much on this forum (and others) regarding various hybrid and mini maze procedures that I’m not sure which is which. I’m looking for information/advice regarding this, or similar, type of ablation. I am in Southern California and have full medical (Medicare) insurance so I can more or less choose my own treatment. Can anyone help me with information so that I can come to a decision?
Hybrid Ablation : I had a consultation... - Atrial Fibrillati...
Hybrid Ablation
Written by
GolfGirl51
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42 Replies
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Hi Golfgirl
As an ex nurse and now a patient I was able to watch both Ablations
done with surgeons working.
One was using a balloon.
Other clipped within the heart.
It was Radcliffe Research UK
Maybe you can google the Company.
Cheri JOY. 73. (NZ)
*I cant have an abrasion because of an enlarged chamber.
Golfgirl was not asking about ablation but hybrid maze/ablation surgery which is an entirely different procedure and not catheter ablation which I think you are describing.
You wouldn’t be awake for this procedure.
There are a very few people who are members of this forum who know a lot about the various forms of maze surgeries - there is one in US called Wolf Maze procedure but done by very few surgeons. Cox-Maze and Mini Maze hybrid ablation is relatively new and because you saw a thoracic surgeon I guess this is what is proposed. The best person to find out about this from is MummyLuv hopefully now I have tagged her she will respond.
There are a handful of posters here who have had this type of surgery/ablation, all of whom seem delighted with their outcomes so hopefully they will chip in soon.
hello, thanks for the tag CDreamer .
A hybrid is a combined catheter ablation and mini maze surgery. It can be done at the same time or staged with mini maze first and catheter ablation as a follow up if needed (I have not needed this as the mini maze alone has been successful but I had lone afib, if you have other arrhythmia’s then you may need both regardless).
If your surgeon/EP is talking about a convergent procedure then rather than coming in between your ribs to carry out the surgery (mini maze) they will come in below your rib cage (convergent). There is also a difference in where they ablate as they tend to ablate the whole of the back wall of the left atrium when using the convergent method whereas a mini maze only does certain lesion sets. The wolf mini maze mentioned above does not ablate the back wall at all.
Surgical ablation (mini maze or convergent) normally isolates the pulmonary veins, clips or staples the left appendage and carries out lesion sets on the back wall of the left atrium all to stop the electrical pulse misfiring. It has a high success rate.
If you want to chat to people who have had a convergent procedure best place I can point you to is the ‘Mini maze and other alternatives for afib’ Facebook page.
PM me if I can help anymore
I had the WO-MM, which is the Wolf Mini Maze performed by Dr Ohtsuka in Tokyo, 17 days ago.You may want to search the Debakey hospital in Houston Texas, where Dr Wolf operates.
All is well to date, in sinus rhythm and no pain at all. It's as if I left my heart at the hospital. All the old sensations and trepidation are gone.
Leaving Tokyo in ten days.
Other side
what a success, so delighted for you Saul 👏👏 I wish more people were able to access mini maze surgery, in my opinion we are the fortunate few. Marsha below too. Marsha was a month after me and I am now at the stage that I’m not thinking about my heart, I’m even getting more confident with exercise and alcohol. GolfGirl51 if you are being offered the procedure as long as you are confident in the experience of your surgeon and understand why a hybrid rather than mini maze only is needed I would have no hesitation in doing it.
I have a friend who has a hybrid in Southern California same day as me and doing amazing! Tanya. You will find her on the group you have just joined. There are three people on there all with the same surgeon.
Thank you Alison, we searched together far and wide and, for me, it is beyond my wildest dreams. You must now be seven months post surgery and in NSR, after quite a few years being persistent. Wishing you a long and healthy life with your wonderful family.
I agree that all who suffer with Afib should be aware of this option.
I thank my lucky stars that I first came across the WMM, completely by chance, on the AFA Association forum. Thank you.
Your posts and others led me to Dr. Wolf and his mini-maze. I urge others to visit his videos at Houston Methodist Hospital to learn more. I had my virtual consult with him and am on the schedule for May, which cannot come soon enough! (Also on the "move-up" list, so with any luck, perhaps a bit sooner ...) Congrats, to Saul (below), too--I followed your posts on the FB group!
How exciting for you. I wish you the best and hope your date will ‘move up’. However, May will come around soon enough. Where are you located if you don’t mind me asking.
Delaware
that’s amazing!
thank you for your reply. I have been following your recent journey on this forum and the Wolf Facebook page. I’m so happy for you.
I am in California and I had the Wolf Mini Maze in Houston Texas on June of this year. Dr Wolf pioneered the procedure and designed or helped design the tools used in it. He believes that lone AFib is a vagal nerve problem and ablates a complete ring around the outside of the heart including the ganglionic plexi nerves. He clips the LAA and does a TEE both during and after the clip to be sure the LAA is completely isolated. This kills the LAA so that no blood thinners are needed ever again for prevention of stroke caused by AFib. The LAA also Carries nerves that can mis fire and cause AFib so that is eliminated as well. The success rate for the WMM is between. 88 and 96% depending on if you are persistent AFib, how long you have been persistent or if you are paroxysmal. The procedure is done at Debakey Heart and Vascular Center at Houston Methodist Hospital. Dr Wolf has been performing this surgery for 20 years and has done thousands. For more info there is a Facebook page Wolf Mini Maze that you can join to get info from patients who are researching and those who have had it done. I had episodes every 5 days for hours before the surgery. I have had zero episodes since the day of surgery, going on six months now.
Good Luck in your research. You can contact Dr Wolf and have a virtual visit with him to find more info and if you are a candidate with no obligation of anything.
Thank you for responding. The procedure I am being offered is a little different I believe. However, the LAA would be clipped during the procedure. I am now in permanent AFib and there are few options available. I’m trying to find the best one for me.
what a great explanation!
I had the WMM procedure in Houston, October 19, 2022. I am doing very well and I certainly cannot add to Poochmom’s excellent explanation.
I will simply add that Houston Methodist is the best hospital I have ever encountered.
Good luck with your research. I am delighted to hear of other options for us fibbers!
Dr. Wolf is 69 years old and can’t be expected to save all fibbers!
I plan to make contact for a consultation. I am quite familiar with Houston as I lived there for about three years (not far from Houston Methodist actually). There are some wonderful medical facilities there. Must say I would rather be closer to home but at least I will know my way around and I still have friends in the area.
probably wise to speak with not only Dr. Wolf but your other surgeon in California and then make your decision.
Of course you know to ask how many of this procedure the surgeon has completed.
Let us know your decision.
I already know - I would be the second 🤣. My sister suggested I ask about the first! It's one of reasons I am hesitant.
However, I guess there was a first etc., for Dr. Wolf.
hmmmmmmm. That would give me pause!
Dr. Wolf has done thousands, no deaths; began in 2003 I believe.
I know, it does a little but he is a Thoracic Surgeon so he knows his way around. Of equal concern about this particular procedure is the extensive scarring by the device to the back of the heart. I'm still researching and keeping a very open mind but I have to do something as I can't carry on like this - well, I can but I don't want to.
oh I get it! Been there done that!
Please let us know your decision and then your surgery date and healing journey!
Evangeline is that you?😂
yes ! Is this Marsha😊💕
why yes it is!❤️😘
love hearing from you on any site😊
You feeling well and getting ready for the holidays?
yes, I am. I am feeling good except incisions are very tender still and my heart rate is a little high than I’d like. In the 80s. But that can take a long time to come down so I’m not worried. How about you?
I’m good! Doc said in NSR since Nov 17 ( some episodes of flutter post- op)
Energy levels started increasing Dec. 5.
Waiting to hear when I can wean off Amiodarone and maybe Diltiazam.
Merry Christmas and a healthy happy new year💕🙏
just so you know the WMM works for permanent AFib. I would encourage you to have a consult with Dr Wolf if for no other reason than to know ALL your options and you can make an informed decision.
Thank you, Poochmom. I have downloaded the forms and next week I will make contact for a consultation.
I would slightly caveat that, dr Wolf has a very high success rate but there is a chance with permanent afib that you may require a catheter ablation after the WMM, that was what he advised me. But that’s no different from any of the mini maze procedures x
great. At least then you will have more information to make the right decision for you. We are blessed to be in the US to have this option available to us. Good luck! I know you will make the best decision for yourself. It is such a blessing to be rid of this awful beast if AF
hi there, here is the name of the hospital and surgeon who has done quite a few hybrids in California in case near you.
Napa, CA's Adventist Hospital. Dr. Dunnington
Thank you so much - off I go to research him. I believe I saw this particular facility referenced in another forum but I've looked at so many.
I have sent an enquiry email so hopefully they will get back to me with more information. I also have contacted Stanford Health Care in Palo Alto who offer a similar procedure. Thank you so much for all of your helpful information.
best of luck
I appreciate MummyLuv giving you the name of a surgeon who has done more than one☺️
Me too. I will certainly look it up.
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