{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T17:07:14Z","timestamp":1783357634157,"version":"3.54.6"},"reference-count":12,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2011,7,1]],"date-time":"2011-07-01T00:00:00Z","timestamp":1309478400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Innovations\ufffd(Phila)"],"published-print":{"date-parts":[[2011,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Transmural and contiguous ablations and a comprehensive lesion pattern are difficult to create from the surface of a beating heart but are critical to the successful treatment of persistent, isolated atrial fibrillation. A codisciplinary simultaneous epicardial (surgical) and endocardial (catheter) procedure (Convergent procedure) addresses these issues.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with symptomatic atrial fibrillation who failed medical treatment were evaluated. Using only pericardioscopy, the surgeon performed near-complete epicardial isolation of the pulmonary veins and a \u201cbox\u201d lesion on the posterior left atrium using unipolar radiofrequency ablation. Simultaneous endocardial catheter radiofrequency ablation completed pulmonary vein isolation, performed a mitral annular and cavotricuspid isthmus line of block, and debulked the coronary sinus. Twelve-month results for the Convergent procedure were compared with 12-month results for concomitant and pericardioscopic (stand-alone transdiaphragmatic\/thoracoscopic) atrial fibrillation procedures using unipolar radiofrequency ablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty-five patients underwent the Convergent procedure (mean age, 62 y; mean body surface area, 2.17 m\n                      <jats:sup>2<\/jats:sup>\n                      ; mean atrial fibrillation duration, 4.8 y; mean left atrial size, 5.2 cm). Ninety-two percent were in persistent or long-standing persistent atrial fibrillation. At 12 months, evaluation with 24-hour Holter monitors found 82% of patients in sinus rhythm, while only 47% of pericardioscopic and 77% of concomitant patients treated with unipolar radiofrequency ablation were in sinus rhythm.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Simultaneous epicardial and endocardial ablation improves outcomes for patients with persistent or longstanding persistent atrial fibrillation. This successful collaboration between cardiac surgeon and electrophysiologist is an important treatment option for patients with large left atriums and chronic atrial fibrillation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/imi.0b013e31822ca15c","type":"journal-article","created":{"date-parts":[[2016,6,15]],"date-time":"2016-06-15T16:02:36Z","timestamp":1466006556000},"page":"243-247","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":25,"title":["Simultaneous Catheter and Epicardial Ablations Enable a Comprehensive Atrial Fibrillation Procedure"],"prefix":"10.1177","volume":"6","author":[{"given":"Andy C.","family":"Kiser","sequence":"first","affiliation":[{"name":"Division of Cardiothoracic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Landers","sequence":"additional","affiliation":[{"name":"FirstHealth Arrhythmia Center, Pinehurst, NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ker","family":"Boyce","sequence":"additional","affiliation":[{"name":"FirstHealth Arrhythmia Center, Pinehurst, NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matja\u017e","family":"\u0161inkovec","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Ljubljana, Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrej","family":"Pernat","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Ljubljana, Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Borut","family":"Ger\u0161ak","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, University Medical Center Ljubljana, Ljubljana, Slovenia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2011,7,1]]},"reference":[{"key":"bibr1-imi.0b013e31822ca15c","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)36684-X"},{"key":"bibr2-imi.0b013e31822ca15c","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2008.03.071"},{"key":"bibr3-imi.0b013e31822ca15c","first-page":"117","volume":"3","author":"Kiser A.C.","year":"2008","journal-title":"Innovations."},{"key":"bibr4-imi.0b013e31822ca15c","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2008.07.066"},{"key":"bibr5-imi.0b013e31822ca15c","doi-asserted-by":"publisher","DOI":"10.1532\/HSF98.20091112"},{"key":"bibr6-imi.0b013e31822ca15c","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2007.08.027"},{"key":"bibr7-imi.0b013e31822ca15c","doi-asserted-by":"crossref","unstructured":"KiserA.C., CockfieldW. Paracardioscopic ex-maze procedure for atrial fibrillation. Multimedia Manual of CardiothoracicSsurgery. 2010. Available at: http:\/\/mmcts.ctsnetjournals.org\/cgi\/content\/full\/2010\/0201\/mmcts.2008.003863. Accessed on August 1, 2011.","DOI":"10.1510\/mmcts.2008.003863"},{"key":"bibr8-imi.0b013e31822ca15c","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eum120"},{"key":"bibr9-imi.0b013e31822ca15c","unstructured":"LongoriaJ., WolffL.J., KimB.H.  Totally thoracoscopic bipolar radiofrequency ablation for the treatment of atrial fibrillation [abstract]. Presented at the Society of Thoracic Surgeons Annual Meeting, January 26\u201328, 2009, San Francisco, CA USA."},{"key":"bibr10-imi.0b013e31822ca15c","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000145172.55640.93"},{"key":"bibr11-imi.0b013e31822ca15c","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2003.165"},{"key":"bibr12-imi.0b013e31822ca15c","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2001.118041"}],"container-title":["Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1097\/imi.0b013e31822ca15c","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1097\/imi.0b013e31822ca15c","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:19:38Z","timestamp":1777461578000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1097\/imi.0b013e31822ca15c"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,7]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2011,7]]}},"alternative-id":["10.1097\/imi.0b013e31822ca15c"],"URL":"https:\/\/doi.org\/10.1097\/imi.0b013e31822ca15c","relation":{},"ISSN":["1556-9845","1559-0879"],"issn-type":[{"value":"1556-9845","type":"print"},{"value":"1559-0879","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,7]]}}}