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Convergent Ex-Maze Update

CBN fo under Pat Robert son has Convergent Procedure at Moore Regional Hospital
Pat RobertsonChristian broadcaster Pat Robertson had a big smile and a brief greeting (“I’m back”) for “700 Club” viewers as he opened the Sept. 8, 2009, telecast of his long-running talk show. Pronouncing himself “as strong as ever,” the founder and chair of the Virginia-based Christian Broadcasting Network (CBN) chatted with co-host Kristi Watts as he explained the reason for his recent extended absence from the show: a stay in FirstHealth Moore Regional Hospital in Pinehurst for a procedure to correct his atrial fibrillation.

Telling his audience that he had suffered for years with the condition that afflicts an estimated 5 million Americans, Robertson said he had tried medication and two ablations to address the problem, but nothing had worked.

Then he heard about Moore Regional Hospital and the Convergent Procedure performed by cardiothoracic surgeon Andy Kiser, M.D., and cardiologist Mark Landers, M.D., and decided to “give it a go.”

“I tell you, my hat’s off to those guys,” Robertson told his CBN audience.

Intrigued by the procedure’s 90 percent success rate, Robertson entered Moore Regional in late-summer 2009 in the care of Drs. Kiser and Landers, who combined their skills as surgeon and cardiologist/electrophysiologist to address his condition. During the procedure, they discovered and Dr. Kiser removed an abnormally enlarged left appendage on Robertson’s heart that apparently was the source of his problem. Robertson spent 10 days in the hospital and within weeks was telling his story to millions of “700 Club” faithful.

The September telecast marking Robertson’s return to the airways included a videotaped feature explaining how the Convergent Procedure works as it told the story of another Convergent success, Montgomery County resident Carolyn Thompson. During the broadcast, the 79-yearold Robertson repeatedly praised Dr. Kiser and Dr. Landers.

“I’m thankful for Andy Kiser and his associate, Mark Landers,” he said. “These are very, very skilled people.”

A thank you from Pat Robertson

Letter from Pat Robertson

To View a Video

Cardiothoracic surgeon Andy Kiser and cardiologist Mark Landers have continued to monitor the progress of Christian broadcaster Pat Robertson by participating in videoconferences and telephone consultations with Robertson and his personal cardiologist in Virginia.

“He’s doing great,” Dr. Kiser says of his famous patient.

The creation of the Convergent Procedure
When Andy Kiser, M.D., a cardiothoracic surgeon at FirstHealth Moore Regional, performed the first Ex-Maze surgery in the United States, it was a concomitant (associated) procedure done in conjunction with a traditional open-chest, stopped-heart coronary bypass. Soon, he was partnering with heart specialists in Europe to develop an Ex-Maze procedure that could be done as a minimally invasive surgery performed on a beating heart and through several small incisions instead of the open chest.

In June 2007, Dr. Kiser, in collaboration with Polish and German heart surgeons, performed the world’s first minimally invasive Ex-Maze on a patient in Krakow, Poland.

Dr. Kiser began offering the minimally invasive Ex-Maze at Moore Regional shortly thereafter. Soon surgeons from such metropolitan locations as Chicago, St. Louis and Sacramento adopted the surgery that cauterizes the heart muscle with heat generated by radio frequency to create a pattern of scar tissue that controls the errant electrical impulses that cause atrial fibrillation.

Continued improvements to the procedure eventually led to an even more effective atrial fibrillation treatment. In January 2009, Dr. Kiser and cardiologist/electrophysiologist Mark Landers, M.D., assembled an international team of surgeons and cardiologists, again in Krakow, to explore a new technique. The resulting surgery combined the skills and expertise of the cardiac surgeon with those of the electrophysiologist so that, in January 2009, a 55-year-old Idaho man could travel to Pinehurst and Moore Regional and become the first patient in the United States to have the Convergent Ex-Maze.

In its various forms, each an improvement over the other, the atrial fibrillation technique has been performed more than 200 times worldwide. The current procedure, called the Convergent Procedure, has been done 40 to 50 times internationally. More than 30 of those surgeries have been performed at Moore Regional Hospital by Dr. Kiser in collaboration with either Dr. Landers or a second Moore Regional electrophysiologist, Ker Boyce, M.D.

Dr. Kiser calls the Convergent “a more comprehensive procedure,” one that addresses the erratic, atrial fibrillationcausing electrical impulses on the inside as well as the surface of the heart.

“I do the surface, and Dr. Landers or Dr. Boyce does the inside,” he says. “We look for areas that are problems, we test for problems, and then we go back and do more. We’ve started to see a merger of the technology and technique. The biggest improvement has been the integration of these systems.” Outcomes, he says, “are fantastic” with the most recent three-month data showing a success rate of about 90 percent.

Ker Boyce, M.D. Andy C. Kiser, M.D. Mark Landers, M.D.

Arrhythmia Center

The FirstHealth Arrhythmia Center offers comprehensive treatment for patients with atrial fibrillation. Once considered a harmless annoyance, atrial fibrillation is now recognized as a dangerous condition that can double the risk of death. Patients with atrial fibrillation are five to seven times more likely to have a stroke, and the disease can also cause congestive heart failure and uncomfortable symptoms related to a rapid heart rate. The FirstHealth Arrhythmia Center offers a unique new treatment for atrial fibrillation called the Convergent Procedure, which combines the minimally invasive Ex-Maze procedure with a catheter ablation. The co-disciplinary treatment was developed by Andy C. Kiser, M.D., a cardiothoracic surgeon and Arrhythmia Center medical director, and Mark Landers, M.D., a cardiologist specializing in electrophysiology.

As demand for the procedure increased, an additional FirstHealth electrophysiologist, Ker Boyce, M.D., has also joined the team.

Atrial fibrillation treatment begins with services provided by a cardiologist but can ultimately require a surgical procedure. Treatment options include medications, electric shock cardioversion, pacemaker therapy and catheter ablation as well as the Convergent Procedure. All are offered at FirstHealth Moore Regional Hospital.