The Hybrid Approach to Endocardial Surgery

The topography of the left atrial appendage really dictates which clip we use for each individual patient. We prefer a staged approach because it allows us to resolve the acute edema before the endocardial procedure is started and it also allows the epicardial lesions to mature. This also is opportune for patients who've had multiple prior catheter based ablations with very good control of their pulmonary veins.