The Hybrid Convergence Lesion Set and the Left Atrial Appendage Clip

The hybrid convergent with the left atrial appendage clip does not utilize cardiopulmonary bypass, it's sternal sparing and minimally invasive. It is able to target both the triggers as well as the substrate in these patients with complex long-standing persistent atrial fibrillation. There are of course some patients who are not candidates for this approach particularly those who have a documented left atrialappendage thrombus or who have significant comorbid valvular or coronary heart disease. These patients obviously should be treated with an open surgical approach and a concomitant coxamase for lesion set. And we start by discontinuing anticoagulation 72 hours pre