Surgical Treatment for Atrial Fibrillation
Atrial fibrillation is the most common type of abnormal heart rhythm. With atrial fibrillation, electrical impulses don't follow a normal pathway through the heart. As a result, the heart doesn't beat properly or pump blood correctly.
Atrial fibrillation can lead to:
- Blood clots
- Heart attack
- Heart failure
- Chronic fatigue
Radiofrequency Ablation for Atrial Fibrillation:
Modified Maze Procedure
University of Chicago heart surgeons have been successfully treating atrial fibrillation for several years, and can offer the most advanced techniques to correct this condition. Surgical ablation, also called a modified Maze procedure or Mini Maze procedure, involves the use of radiofrequency waves (modified electrical energy) to create precise scar lines on the heart's surface. These scars redirect the erratic electrical impulses of atrial fibrillation to follow a normal electrical pathway through the heart. Our surgeons use specially designed instruments to deliver the radiofrequency waves to the abnormal heart tissue.
This operation is frequently performed in conjunction with other heart surgeries, such as mitral valve repair or coronary artery bypass, but is also performed as a stand-alone procedure for patients with atrial fibrillation. This procedure can be performed through one or two very small incisions (minimally invasive). The minimally invasive approach is performed with the use of a videoscope. Like many other heart surgeries performed here, surgical radiofrequency ablation can be done on a beating heart and does not require use of a heart-lung machine.
Benefits of the Procedure
Surgical radiofrequency ablation for atrial fibrillation offers the following benefits:
- 75 to 90 percent cure rate of atrial fibrillation
- Reduction in risk of blood clots and stroke
- Fewer or no symptoms related to abnormal heart rhythms
- Reduction or discontinuation of blood thinners such as Coumadin
- Reduction or discontinuation of anti-arrhythmic drugs such as Amiodarone
- Most patients who have had the procedure report an ability to exercise more frequently and for longer periods of time
- In some cases, the procedure will reduce the size of the atria, therefore lessening the risk for other complications, such as heart failure
Minimally Invasive Approach Offers Added Benefits
Additional benefits of the minimally invasive approach include:
- No splitting of the breastbone (sternum)
- Faster recovery than with a large chest incision
- Less time spent in the hospital
- Less pain, because the incisions are small
- Minimal blood loss
- Little scarring
Who is a candidate for surgical treatment of atrial fibrillation?
Radiofrequency ablation for atrial fibrillation is an option if:
- You have chronic atrial fibrillation
- Your atrial fibrillation is not well controlled by medication
- You have intermittent atrial fibrillation that is disabling
- You require another type of heart surgery procedure, such as mitral valve surgery or coronary artery bypass surgery
- You have a history of stroke or cannot take Coumadin
How is the radiofrequency approach better than the Maze procedure?
You may have heard about the Maze procedure, a surgical approach to treating atrial fibrillation that entails precise cutting of heart tissue to stop the abnormal heart rhythms. While this is an effective approach to treat atrial fibrillation, it does pose greater risks and complications than the radiofrequency approach.
In contrast to the Maze procedure, surgical radiofrequency ablation (modified Maze procedure) offers the following benefits:
- Less scarring to heart tissue
- No need to use a heart-lung machine
- No cutting of heart tissue
- Significantly shorter operative time
How is surgical ablation different from catheter ablation?
Catheter ablation is similar to surgical ablation in the sense that both procedures are performed for the same purpose and they both use radiofrequency waves to treat abnormal heart rhythms. Catheter ablation involves the use of a catheter that is threaded through the leg and into the heart. The catheter is equipped with a device that delivers radiofrequency waves to the source of the arrhythmia. An electrophysiologist performs this procedure in a catheterization lab.