AANA April 2025 Journal Course : Anesthetic Considerations for the Convergent Plus Procedure: A Hybrid Approach to the Treatment of Nonparoxysmal Atrial Fibrillation-AANA Journal: Anesthetic Considerations for the Convergent Plus Procedure: A Hybrid Approach to the Treatment of Nonparoxysmal Atrial Fibrillation

AANA Journal: Anesthetic Considerations for the Convergent Plus Procedure: A Hybrid Approach to the Treatment of Nonparoxysmal Atrial Fibrillation

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The article from the AANA Journal focuses on the Convergent Plus Procedure, an innovative treatment for managing nonparoxysmal atrial fibrillation (AF). This condition is expected to affect 12.1 million people in the United States by 2030. Traditional treatments for persistent AF often yield limited results, prompting the development of this hybrid method.<br /><br />The Convergent Plus Procedure integrates surgical epicardial ablation, percutaneous endocardial ablation, and left atrial appendage (LAA) occlusion. It shows promise by being twice as effective as endocardial ablation alone and reducing the need for AF medications by half. The approach is performed in cardiac operating rooms and hybrid cardiology suites nationwide, emphasizing the need for interdisciplinary coordination among surgery, cardiology, and anesthesiology teams.<br /><br />The anesthetic management of this procedure is complex and is detailed throughout the article. It requires certified registered nurse anesthetists (CRNAs) to understand specific procedural stages, maintain proper patient positioning, manage lung isolation, and handle potential complications like hemodynamic instability, hemorrhage, and stroke. The document outlines essential stages of the procedure, crucial anesthetic considerations, and complications associated with each stage, including the risk of esophageal thermal injury and phrenic nerve damage.<br /><br />The article also highlights contraindications, such as the presence of thrombus within the heart, and offers insights into procedural contingencies. Overall, the Convergent Plus Procedure holds significant promise for effectively treating atrial fibrillation, necessitating detailed perioperative planning and precise interdisciplinary coordination to improve patient outcomes. Continued research and collaboration among healthcare professionals are crucial for advancing this procedure and ensuring its efficacy and safety in treating nonparoxysmal AF.

Keywords

Convergent Plus Procedure

nonparoxysmal atrial fibrillation

surgical epicardial ablation

percutaneous endocardial ablation

left atrial appendage occlusion

anesthetic management

interdisciplinary coordination

CRNAs

cardiac operating rooms

perioperative planning