• Agnieszka Trzcinka, Lawrence S Lee, Christopher Madias, Munther K Homoud, Hassan Rastegar, Gregory S Couper, and Frederick C Cobey.
• Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Boston, MA. Electronic address: atrzcinka@gmail.com.
• J. Cardiothorac. Vasc. Anesth. 2021 Feb 1; 35 (2): 631-643.

AbstractThe convergent procedure is a hybrid ablation treatment for atrial fibrillation. It is increasingly considered as a management option for patients with persistent and long-standing atrial fibrillation. It consists of surgical ablation of the posterior left atrium through a minimally invasive closed-chest approach followed by endocardial catheter ablation. It is increasingly performed with concurrent epicardial occlusion of the left atrial appendage with a video-assisted thoracoscopic technique to physically and electrically isolate the left atrial appendage. This article provides an overview of a multidisciplinary approach to the convergent procedure, with concurrent thoracoscopic closure of the left atrial appendage, with an emphasis on perioperative management at a single institution. It provides a literature review of procedural outcomes, current data limitations, and future considerations.Copyright © 2020 Elsevier Inc. All rights reserved.

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