International Heart Institute among first on West Coast to offer robotic-assisted atrial fibrillation procedure

Loma Linda University Health International Heart Institute is among the first on the West Coast to offer a cutting-edge hybrid procedure for atrial fibrillation (AFib), a condition that causes an irregular and often rapid heart rhythm. This innovative approach combines the robotic platform surgically and catheter-based techniques to improve treatment success, particularly for patients with persistent AFib who have not responded to conventional therapies. By integrating these methods, the procedure offers new hope for those seeking a more effective, long-term solution to restore normal heart rhythm and reduce complications.

A Two-Stage Approach to AFib Treatment

Joshua Chung, MD, department chair of cardiothoracic surgery, says that the robotic hybrid procedure is a two-step process designed to maximize treatment effectiveness.

Step 1: Surgical Approach

The first step of the procedure involves a minimally invasive surgical ablation, performed by a cardiothoracic surgeon. Using small incisions with the da vinci Robot, the surgeon accesses the heart through the chest and applies controlled radiofrequency energy to create precise lesions on the exterior of the heart’s left atrium. These lesions help block the faulty electrical signals that cause AFib and allow normal electrical conduction to take over. Unlike traditional open-heart surgery, this method is less invasive, reducing recovery time and lowering the risk of complications. The usage of the robot allows the surgeon with improved visualization and dexterity to maximize the ability to perform the necessary ablations while minimizing incisions.

Step 2: The Catheter-Based Approach

Following the surgical ablation, an electrophysiologist performs a catheter-based ablation to refine and reinforce the treatment. A catheter is inserted through a vein, typically in the groin, and guided to the inside of the heart. Using either radiofrequency or cryotherapy, the electrophysiologist targets any remaining abnormal electrical pathways that were not fully addressed by the surgical ablation. This step ensures a more thorough and effective treatment, particularly for patients with complex AFib cases.

“By combining these two complementary techniques, the robotic hybrid procedure enhances the success rate of AFib treatment, offering patients a better chance at long-term rhythm control and reducing their risk of stroke, heart failure, and other AFib-related complications,” Chung says.

Effectiveness and Long-Term Outcomes

Traditional open-heart surgery for AFib boasts success rates greater then 90% and the hybrid approach aims to achieve similar outcomes with a less invasive technique.

Who Are Ideal Candidates?

The robotic hybrid procedure is particularly beneficial for:

• Patients with longstanding, persistent AFib, lasting over a year.
• Patients who have undergone previous catheter ablations but continue to experience AFib episodes.

For these individuals, the hybrid approach offers a promising alternative when conventional treatments have not provided lasting relief.

Patient Awareness and Hesitancy

Many patients with AFib may not immediately recognize their condition, as symptoms vary widely. Some experience noticeable palpitations, fatigue, or shortness of breath, while others remain asymptomatic. According to Chung, patients who have already undergone failed catheter ablations are more receptive to trying the hybrid procedure.

While LLUH utilizes robotic-assisted surgery for many procedures, the robotic aspect is not typically a major concern for patients. Instead, hesitancy often stems from undergoing surgery itself. Chung reassures patients that this method is designed to be minimally invasive while maintaining high effectiveness.

“Not many surgeons perform this procedure yet, but we expect demand to grow as awareness increases,” Chung says. “We’re proud to offer this innovative approach and help patients regain normal heart rhythm when other treatments have not succeeded.”

Patients seeking advanced AFib treatment can schedule a consultation with LLUH’s expert cardiology team to determine if the hybrid procedure is right for them.