UK HealthCare expands options for patients with persistent AFib

LEXINGTON, Ky. (Aug. 6, 2026) — For Kathie Kok, atrial fibrillation, or AFib, didn’t arrive with one dramatic moment. She started experiencing more fatigue, less energy and the sense that something just wasn’t right.  

She was once active and always on the go, so when she found herself slowing down and couldn’t figure out why, it was time for her to speak with a doctor.  

At 78 years old, Kok was diagnosed with AFib, an abnormal heart arrhythmia causing an irregular and often very rapid heart rhythm.  

“I led a perfectly active lifestyle before I got AFib,” Kok said. “Then I became more tired and run down frequently.”  

Common symptoms of AFib include fatigue, fluttering, heartbeat (palpitations), chest pain and shortness of breath. Sometimes patients, like Kok, don’t realize they have AFib and don’t have any obvious symptoms.  

AFib occurs when the heart is out of its regular rhythm. Essentially, the heart is stimulated by signals released from regions that are not part of its normal electrical system. With AFib, those signals are chaotic and disorganized, causing the heart to beat irregularly and often rapidly. 

AFib can be common especially as people get older, but if it’s not treated, it causes a shorter life expectancy. If left unmanaged, AFib can cause strokes, early-onset dementia, blood clots in the heart, heart failure and, ultimately, early death.  

When Kok was diagnosed with AFib, her doctors tried to restore her heart rhythm through more traditional treatments like cardioversion. But after multiple attempts, her heart continued to return to AFib. The treatments weren’t enough to keep her in a normal rhythm. 

“They tried to get me back in rhythm, but it didn’t stick,” Kok said. “That was unsettling and I knew the risks I faced being in AFib. It was scary and I just wanted to be back in my regular routines.”  

Kok was then referred to cardiology at the UK HealthCare Gill Heart & Vascular Institute. The goal was to find other treatment options that would keep her heart in the correct rhythm and out of AFib long-term.  

In 2018, Tessa London-Bounds, M.D., cardiothoracic surgeon at Gill Heart & Vascular Institute, completed her super-fellowship in AFib surgery at Washington University, bringing a new treatment option to patients at UK HealthCare. In partnership with UK’s electrophysiologists (EP), the hybrid AFib treatment program has been developed.  

This treatment is a hybrid procedure that combines a minimally invasive surgical ablation with electrophysiologist ablation and mapping to ensure the highest chances of getting patients suffering from long-standing persistent AFib in a normal sinus rhythm. It is a true collaboration between cardiothoracic surgery and electrophysiology to ensure patients get the best long-term care available.    

The hybrid AFib program is designed for patients with persistent or longstanding AFib whose condition can be harder to treat with standard approaches alone. This program has also collaborated with other specialties to ensure patient support in areas that could be exacerbating AFib. For example, the weight loss clinic and sleep study clinics can provide additional information allowing patients to get a true holistic long-term treatment plan for their atrial fibrillation that is unique to the UK HealthCare. 

“It’s a treatment option that is personalized for each patient,” London-Bounds said. “We’re combining the best that the surgical aspect provides and the best that the EP lab provides, and we are personalizing it for these very particular kinds of patients. They receive the best of both worlds. They have the least high-risk option, but with the most efficacy.” 

Kok was the right candidate for the hybrid AFib program. London-Bounds and Kristin Ellison, M.D., electrophysiologist at Gill Heart & Vascular Institute, worked together as part of a multidisciplinary effort to restore Kok’s heart to a normal heart rhythm and improve long-term outcomes.  

In recent years, the way physicians think about AFib has evolved significantly. In the past, treatment often focused largely on controlling the heart rate and reducing stroke risk with blood thinners, especially if a patient was not highly symptomatic. More recent evidence has shown that restoring and maintaining a normal rhythm can be better for patients overall. 

“AFib is a progressive disease,” Ellison said. “Patients may move from intermittent episodes to more persistent forms over time, and the longer they remain in AFib, the more difficult it can become to restore normal rhythm.” 

Catheter-based treatment can be highly effective earlier in the disease process, but success rates drop in longstanding persistent AFib, which is why the hybrid program addresses a population that historically has had fewer good options.  

The hybrid approach combines the strengths of cardiac surgery and electrophysiology in a staged treatment plan. During the surgical portion, London-Bounds uses a minimally invasive approach rather than opening the chest through a full sternotomy.  

She treats areas on the outside of the heart that can be difficult to address completely or safely from the inside. 

About a month later, after the heart has had time to recover from the first part of treatment, the patient returns for a catheter-based completion procedure in the electrophysiology lab. Ellison maps the heart’s electrical activity, isolates the pulmonary veins and touches up any remaining areas that need treatment.  

“The two-part strategy is what makes the treatment different from traditional approaches,” Ellison said.  

Standard catheter ablation works from inside the heart and remains an important treatment option, especially for earlier AFib. Maze surgery can also be highly effective but historically has been more invasive and often reserved for patients already undergoing another heart operation.  

The hybrid model is designed to offer a less invasive surgical option while pairing it with a catheter-based completion procedure to create a more durable result in patients with advanced disease.  

“In longstanding persistent AFib, a catheter procedure alone may offer about a 50% to 60% success rate, while the hybrid approach can raise that closer to 80%,” Ellison said. “Published data on hybrid convergent approaches in persistent and longstanding persistent AFib similarly show improved effectiveness compared with endocardial ablation alone, but patient selection and procedural risk remain important considerations.”  

London-Bounds compares normal heart conduction to a conversation following the right path, while AFib is like “people stopping to talk in the hallway” and interrupting that primary conversation.  

“The goal of ablation is to create scar tissue that blocks those disruptive signals and guides the heart back to its natural rhythm,” London-Bounds said. “That matters not only for how patients feel in the moment, but for their long-term health.” 

One of the goals for the providers in the hybrid program is to clearly communicate to their patients and make sure they know exactly how the treatment works and what outcomes they can expect. It’s about breaking down the procedure in a way they can understand which builds trust between the provider and patient. 

For Kok, trust was a big part of her experience.  

“I just trusted that this was the right path for me to take and believed in the team that was going to treat me,” Kok said. “Once I began the process at UK, I was struck by how seamlessly the teams worked together. The doctors worked so well together. They were knowledgeable and explained the whole procedure to me in a way I could understand. I had full trust in them.”  

Recovering from any procedure, especially at an older age, can have its challenges. But, with the hybrid treatment being minimally invasive, the goal is to have a quick recovery.  

Kok remembers being sore for a while and needing to rest. It took some time to get back to her normal routine, but the results made the journey worthwhile.  

“I feel great now,” Kok said. “Once I recovered from the procedures, I was able to be more active again and do the things I love. I have my energy back and feel like myself again. I don’t feel my age and that’s a blessing.” 

Since receiving the hybrid treatment, Kok has remained in regular rhythm and has not returned to AFib for nearly two years. 

This type of outcome is exactly what motivates the hybrid AFib program team. 

“Many patients simply don’t feel like themselves when they have longstanding AFib,” London-Bounds said. “Even if they have adapted enough that the decline happens gradually. Some stop doing activities they enjoy, schedule their days around fatigue or dismiss their symptoms as part of aging.” 

When patients return to a normal rhythm, for some, the difference can be immediate and striking. 

“It’s rewarding to have a part in giving people that part of their life back,” Ellison said. “For some patients the benefit is physical, for others it is peace of mind and for many it is both.”  

The AFib program at the Gill Heart & Vascular Institute is about more than two physicians and two procedures. Both London-Bounds and Ellison emphasize that the best outcomes depend on a broader team-based model that addresses the whole patient. 

Along with cardiac surgery and electrophysiology, the program works closely with primary care physicians, pulmonology for sleep apnea evaluation, weight management specialists, emergency medicine providers and others.  

The goal is not only to treat AFib, but also to identify and manage the factors that can drive it, including obesity, obstructive sleep apnea, hypertension and other chronic conditions. This type of comprehensive care aligns with broader AFib guidance that emphasizes lifestyle changes and risk-factor reduction as essential parts of treatment.  

“The vision is to build a truly centralized AFib program where patients can be directed quickly to the right specialists and receive coordinated, patient-centered care from diagnosis through long-term follow-up,” London-Bounds said. 

That vision also fills an important need for patients in Kentucky. 

Larger academic centers around the country may offer similar hybrid programs, but access remains uneven, and many options in the region were disrupted during the COVID-19 pandemic.  

In Lexington, UK HealthCare is currently the only local program providing this hybrid approach with the extensive built-in interdisciplinary network to the supporting specialties, which means patients no longer have to leave their support systems and travel elsewhere for advanced AFib care.  

For Kok, access changed everything. Today, she describes herself as both relieved and grateful.  

Looking back, what stands out most is the confidence she felt in the care team and the difference treatment made in her daily life. 

“I received wonderful care,” Kok said. “Beyond that, they made me feel confident that everything was going to be all right, and it was. I’m feeling great.”  

Kok now recommends the option to other people she knows facing AFib, especially those who may feel discouraged after earlier treatments failed.  

“I hope this shows patients that even if someone has lived with AFib for years, they may still have options,” Ellison said. “Everyone deserves a chance to be out of AFib, especially now that better tools, better evidence and stronger collaboration are changing what treatment can look like.” 

For patients like Kok, that chance has meant more than a corrected heart rhythm. It has meant the return of energy, confidence and a fuller, longer life.