Concierge cardiothoracic · London
Convergent hybrid AF procedure - private in London.
A staged or same-setting hybrid procedure that combines minimally-invasive epicardial ablation of the posterior left atrial wall, performed by a cardiothoracic surgeon, with catheter-based endocardial pulmonary vein isolation by a consultant electrophysiologist. Designed for persistent and long-standing persistent AF where catheter ablation alone has a lower ceiling.
Why patients choose us
- 01
A subspecialty consultant
A UK cardiothoracic surgeon and electrophysiologist paired for hybrid AF work, not a generalist on a list.
- 02
Booked in weeks, not months
Coordinated surgical and EP diaries across London's high-volume hybrid centres.
- 03
Independent, and free
We take no fee from clinics, so the recommendation is impartial and costs you nothing.
Indicative pricing
What the private Convergent hybrid AF procedure costs in London.
Indicative all-inclusive ranges across our London partner units. Send the details and we quote firm figures with cover checked.
In short
Convergent hybrid AF procedure in our London network: £28,000-£45,000, results reviewed at 12 months.
| Procedure | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Convergent hybrid AF procedure (all-inclusive) | £28,000-£45,000 | Staged over 4-6 weeks | 12-month rhythm review |
| Surgical epicardial stage only | £18,000-£26,000 | 2-3 hours | 2 nights hospital |
| Catheter endocardial stage only | £10,000-£18,000 | 2-3 hours | Day case |
| Consultant consultation | £250-£450 | 45-60 min | Same visit |
Prices vary by hospital, by the paired consultants and by whether the two stages are performed same-day or 4 to 6 weeks apart. Staged protocols usually cost slightly more due to two admissions.
The problem
The right hybrid procedure, at the right time, with the right paired team.
Persistent AF has a lower ceiling with catheter ablation alone. Hybrid ablation opens the posterior LA wall to durable lesions that a catheter simply cannot reach reliably.
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Persistent AF is hard to fix
Catheter ablation alone has a lower success rate in long-standing persistent AF because the posterior LA wall is difficult to reach from inside the heart.
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The right team matters
Hybrid outcomes depend on a paired surgeon and electrophysiologist working together at a high-volume centre, not a hospital brand.
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Insurer processes are opaque
We handle preauth, coding and any second-opinion requirements on your behalf across both surgical and EP stages.
The journey
From enquiry to 12-month rhythm review - what happens, in order.
One coordinated team across both surgical and EP stages. The commonest UK protocol stages the two phases 4 to 6 weeks apart; experienced centres offer a same-day option.
- 01
Before
Send us your history
Symptoms, AF duration, prior ablations, echo and any recent Holter data.
- 02
Before
Match to the hybrid team
A surgeon and electrophysiologist paired for your case at a high-volume London centre.
- 03
Before
Pre-op workup
CT left atrium, transoesophageal echo, bloods and anaesthetic review.
- 04
On the day
Epicardial surgical stage
Subxiphoid access; posterior LA wall radiofrequency lesions by the cardiothoracic surgeon.
- 05
On the day
Endocardial catheter stage
PVI and complex fractionation lesions by the electrophysiologist, same day or 4 to 6 weeks later.
- 06
After
Discharge and report
Typically two nights after the surgical phase; day-case for the catheter phase.
- 07
After
Follow-up and rhythm review
Consultant review at 3, 6 and 12 months with rhythm monitoring.
When it helps
When the Convergent hybrid procedure is the right step.
Patient profiles where a hybrid strategy has a real edge over a repeat catheter ablation.
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Persistent AF over 1 year
Continuous AF for more than 12 months where catheter ablation alone has a lower ceiling.
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Long-standing persistent AF
Continuous AF for over 12 months, often with an enlarged left atrium.
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Failed previous catheter ablation
Recurrent AF after one or more standard PVI procedures.
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Enlarged left atrium
LA diameter over 45 mm where posterior wall isolation adds real benefit.
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Avoiding open surgery
Patients who want a rhythm-control strategy without a full maze or thoracotomy.
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Symptom burden despite drugs
Ongoing breathlessness, palpitations or fatigue on amiodarone, sotalol or flecainide.
Evidence
CONVERGE trial and UK outcomes
The CONVERGE randomised trial, published in 2020, reported 67% freedom from atrial fibrillation at 12 months after Convergent hybrid ablation for persistent AF, compared with 50% for catheter ablation alone. The advantage widened in patients with long-standing persistent AF and enlarged left atria, where posterior wall isolation is the missing piece a catheter cannot reliably deliver. UK high-volume hybrid centres report similar or better freedom from AF at 12 to 24 months when patient selection is careful, and the technique has since been adopted at several London teaching hospitals as a mainstream option after failed catheter ablation.
Procedure options
Options within the Convergent hybrid procedure.
Protocol, timing and add-ons are tailored by the paired team to your anatomy and rhythm history.
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Staged Convergent (standard)
Surgical epicardial phase first, catheter endocardial phase 4 to 6 weeks later. The commonest UK protocol.
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Same-setting Convergent
Both phases on the same day at experienced hybrid centres. Fewer admissions, longer single procedure.
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Convergent with LAA clip
Left atrial appendage clip placed via the subxiphoid port for stroke risk reduction.
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Redo Convergent
Considered after a first hybrid procedure with mapped gaps at the posterior wall or PV ostia.
Where it is done
A small panel of London hybrid AF centres, we picked them.
Introductions are made privately, once we understand your case. The Convergent hybrid procedure in London is offered at Royal Brompton, Bart's Heart Centre Private, King's Private and Guy's and St Thomas' Private.
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CQC-registered London teaching hospitals with paired surgical and EP hybrid programmes
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UK GMC-registered cardiothoracic surgeons and consultant electrophysiologists working as a fixed pair
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Coordinated pre-op workup: CT LA, transoesophageal echo and anaesthetic review
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Direct insurer preauth handling for Bupa, AXA, Vitality, Aviva, WPA and Cigna
Safety and recovery
What to expect afterwards - honestly.
Expect two nights in hospital after the surgical phase and a day-case admission for the catheter phase. Office work returns at 2 weeks, driving at 4 to 6 weeks, exercise at 6 to 8 weeks. A 3-month blanking period follows, during which arrhythmia recurrence does not predict long-term failure.
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Pericardial effusion
Small effusions are common after the epicardial phase and usually settle without drainage.
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Cardiac tamponade
Rare; identified early by intra-op imaging and post-op echo.
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Atrio-oesophageal fistula
A rare but serious late complication; posterior wall lesion protocols reduce risk.
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Bleeding at the subxiphoid port
Usually minor; managed conservatively at experienced centres.
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Phrenic nerve irritation
Uncommon; diaphragmatic function is checked intra-op.
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Blanking-period arrhythmias
AF and flutter in the first 3 months are common and do not predict long-term failure.
Reading your notes
Your report in four parts. Read the last one first.
Whichever London centre performs the procedure, the operative and EP reports keep to the same shape.
- 01 Header
Indication and consent
Why hybrid ablation was chosen and what was consented for both stages.
- 02 Findings
Surgical and EP lesion sets
The posterior wall, PV ostia and any additional lesions, with block confirmed.
- 03 Assessment
Consultant interpretation
What the lesion set means for rhythm control and the blanking-period plan.
- 04 Impression
Summary and next step
Read this first: expected freedom from AF, monitoring plan and follow-up.
Recognised by major UK insurers
Usually covered by UK private medical insurance when there is a specialist referral and documented persistent or long-standing persistent AF.
Frequently asked
Everything we get asked about the Convergent hybrid AF procedure.
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What is the success rate of the Convergent hybrid AF procedure?
The CONVERGE trial reported 67% freedom from AF at 12 months for persistent AF compared with 50% for catheter ablation alone. UK hybrid centres report similar or better outcomes in long-standing persistent AF.
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How long is recovery after the Convergent procedure?
Most patients return to office work at 2 weeks, driving at 4 to 6 weeks and full exercise at 6 to 8 weeks. The subxiphoid incision heals quickly with minimal scarring.
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Will I need a repeat procedure?
Around 10 to 20% of patients need a top-up catheter ablation within 2 years to close gaps in the lesion set. This is usually a straightforward day-case procedure.
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Can I stop anticoagulation after the Convergent procedure?
Anticoagulation is continued for at least 3 months, then reviewed against your CHA2DS2-VASc score. Many patients with additional stroke risk factors stay on treatment long-term.
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Is the Convergent procedure covered by UK private medical insurance?
Yes with a specialist referral and documented persistent or long-standing persistent AF. Bupa, AXA, Vitality, Aviva, WPA and Cigna are the mainstream insurers we work with, and we handle the preauth paperwork.
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What is the blanking period and why does it matter?
The blanking period is the first 3 months after ablation when AF or atrial flutter can occur as the lesions heal. Recurrences during this window do not predict long-term failure and are usually managed with short-term rhythm control drugs.
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Insurer preauth
We handle the paperwork.
Learn more
Ready when you are
Talk to a UK team about the Convergent hybrid AF procedure in London.
Send your history and we pair you with a cardiothoracic surgeon and electrophysiologist at a high-volume London centre. Insurer preauth handled end to end.