Loma Linda University Health International Heart Institute is among the first in the western United States to offer a groundbreaking hybrid procedure for treating atrial fibrillation (AFib)—a common heart rhythm disorder that can lead to serious complications such as stroke or heart failure. This innovative, two-stage approach combines robot-assisted surgery with catheter-based techniques to improve treatment outcomes, especially for patients with persistent or long-standing AFib who have not responded well to conventional therapies.

By integrating both surgical and minimally invasive methods, the hybrid procedure provides a more comprehensive and effective option for restoring a regular heart rhythm and reducing the long-term risks associated with AFib.

A Two-Stage Approach to AFib Care

According to Dr. Joshua Chung, Chair of Cardiothoracic Surgery, the hybrid procedure is carefully designed in two stages to enhance success and minimize recovery time.

Stage 1: Robot-Assisted Surgical Ablation

The first step involves a minimally invasive surgical ablation, performed through small incisions in the chest using the da Vinci robotic system. This advanced platform gives the surgeon enhanced precision and visibility to create targeted lesions on the outer wall of the left atrium. These lesions help interrupt the abnormal electrical signals responsible for AFib and allow the heart’s normal rhythm to resume. Compared to traditional open-heart surgery, this method significantly reduces trauma, shortens recovery, and lowers complication risks.

Stage 2: Catheter-Based Refinement

Once the surgical portion is complete, an electrophysiologist follows up with a catheter-based ablation to fine-tune the results. A catheter is inserted through a vein—usually in the groin—and guided to the interior of the heart. Using either radiofrequency energy or cryotherapy, the specialist targets any remaining abnormal pathways. This step ensures a more thorough treatment, especially beneficial for complex cases.

“By combining these two complementary techniques, we’re able to improve long-term rhythm control and reduce the risk of stroke, heart failure, and other complications of AFib,” says Dr. Chung.

Improving Long-Term Outcomes

While traditional open-heart surgeries for AFib often achieve over 90% success, the robotic hybrid method aims for similar effectiveness through a far less invasive approach—making it an attractive option for patients worldwide.

This hybrid procedure is particularly well-suited for patients with persistent or long-standing AFib lasting more than 12 months, and those who have had previous unsuccessful catheter ablations.

For these individuals, the hybrid approach offers a new path forward when other treatments have not delivered lasting relief.

Addressing Patient Awareness and Concerns

Many people with AFib may not immediately recognize their condition. Some experience symptoms like fatigue, heart palpitations, or shortness of breath, while others feel no symptoms at all. For patients who have already undergone failed treatments, the hybrid procedure often provides renewed hope.

Although robotic surgery may seem intimidating to some, Dr. Chung explains that the bigger concern is often the idea of surgery itself—not the robotic component. “This procedure is designed to be as minimally invasive as possible, while maintaining excellent outcomes,” he says. “Few centers currently offer it, but we expect global demand to grow as more patients and physicians learn about its potential.”

The original article was published on the Loma Linda University Health website.