Living in Manawa, about an hour west of Green Bay, Alan Moede enjoys spending time outdoors. Ice fishing, snowmobiling and hiking are some of his favorite pastimes, but they became difficult to continue when his heart condition, atrial fibrillation (AFib), put him at risk of sudden cardiac arrest. Alan’s doctor prescribed a defibrillator vest for him to wear that would monitor his heartbeat and, if needed, shock his heart into normal rhythm.

“For months, I wore the vest all day and night, except when I showered,” Alan said. “It was stressful because at any moment I knew it could sound an alarm and shock me. I needed surgery, but my doctor didn’t think I would survive it. When I called the Froedtert & the Medical College of Wisconsin heart team to see if they would take my case, I felt like it was my last hope.”

A Second Opinion for Cardiac Care

Mario Gasparri, MD

The next day, Alan drove to Froedtert Hospital, the academic medical center of the Froedtert & MCW health network, for an appointment with Mario Gasparri, MD, cardiothoracic surgeon and MCW faculty member. A week later, he was scheduled for surgery. 

“It was a huge relief,” Alan said. “I knew I was in good hands, and they had the expertise to treat me. Everyone was very knowledgeable and kind.”  

Minimally Invasive Hybrid Ablation Procedure

Alan had long-standing and persistent AFib, which is an irregular heartbeat that lasts for more than a year and does not respond well to treatment. People with this type of AFib are often treated with a surgical method that requires them to be on a heart-lung machine during the procedure.

A lower risk option, called a hybrid ablation or a convergent procedure, is a better choice for some people. The convergent procedure is a dual approach that involves two separate ablations, one on the outside of the heart and one on the inside.

An ablation treats an irregular heart rhythm by using heat to create tiny scars in precise locations that change the heart’s electrical signals to restore a normal rhythm. Typically, the first step is the ablation to the outside of the heart muscle, which is done by a cardiothoracic surgeon. Eight to 12 weeks later, an electrophysiologist does the ablation to the inside of the heart muscle, which is a catheter-based procedure.

“Most people feel better and are in normal rhythm as soon as the first ablation is complete,” Dr. Gasparri said. “But the effects do not last without the second ablation — both need to happen to maximize the benefit. The convergent procedure has a high success rate, and thanks to our technique using the robot, we can do the surgery on people who might otherwise be considered inoperable.”

Leading the Way with Robotic-Assisted Surgery

Most centers do the convergent procedure with an incision below the ribcage, but the Froedtert & MCW cardiothoracic surgery team developed a unique, minimally invasive technique with the use of the da Vinci® robotic surgical system. Dr. Gasparri and his colleague, Stefano Schena, MD, PhD, cardiothoracic surgeon and MCW faculty member, pioneered the technique in 2021. They have since taught it to physicians at other centers, including in Italy.

“We make tiny port hole incisions on the left side of the chest,” Dr. Gasparri said. “The robot gives us better magnification and visualization, and the dexterity of the robotic arms allows for extreme precision in the placement of the ablation lines. Another advantage is the quick recovery patients experience with this approach.”

A Skilled Heart Team for Lasting Results   

Alan’s first ablation was in May 2023. At the same time, Dr. Gasparri placed an AtriClip®, a device to close off the heart’s left atrial appendage, an area where blood tends to pool in people with AFib. Blood pooling can lead to a clot, so the clip significantly reduces Alan’s risk of a stroke due to AFib. After his surgery, Alan spent the night at the hospital and went home the next day.

He returned for his second ablation in July 2023 with James Oujiri, MD, electrophysiologist and MCW faculty member. Within a few months, Alan was able to stop taking some of his AFib medications.

“I honestly felt great immediately after,” Alan said. 

“Without the heart team at Froedtert Hospital, I’m afraid I might have died. I certainly wouldn’t be feeling this healthy. Before, I would get out of breath just tying my shoes. Now, I’m back to biking, hiking, fishing and other activities.”


World-class experts on the Froedtert & MCW heart and vascular team offer innovative treatments based on the latest techniques and research. Learn more at froedtert.com/heart-care