New Heart Procedure for A-Fib Patients
Increases effectiveness of the ablation medical procedure for persistent Atrial Fibrillation
Hybrid maze ablation/atrial fibrillation is a procedure that is the surgical ablation approach with the greatest long-term success in treating atrial fibrillation. The new maze heart procedure for A-Fib includes creation of line of conduction block (scar tissue) that blocks the abnormal impulses that cause atrial fibrillation, enabling restoration of normal sinus rhythm.
The maze procedure is an operation to treat atrial fibrillation (A-Fib or AF), a type of irregular heartbeat. What is a maze procedure? The maze procedure creates scars in strategic places in the atria (the heart’s two upper chambers). This creates a “maze” of scar tissue that the surgeon creates with the application of cold energy (cryoablation).
What is atrial fibrillation?
Atrial fibrillation (AF or A-Fib) is the most common abnormal heart rhythm. Atrial fibrillation is an irregular, frequently rapid heart rhythm originating in the atria (top chambers of the heart). Instead of the normal sinus rhythm in which a single impulse travels in a hasty manner through the heart, in AF many impulses begin simultaneously and spread through the atria, causing a rapid and disorganized heartbeat.
Advances in Ablation
Possibility of cure to many patients
The goals of treatment for atrial fibrillation include regaining a normal rhythm, controlling the heart rate, preventing and reducing the risk of stroke.
At one time, a-fib was thought to be a harmless annoyance. However, atrial fibrillation is now recognized as a dangerous condition. Atrial fibrillation doubles the risk of death and increases the risk of stroke five to seven times compared to a person without fibrillation. Learn more about a-fib,
Medical Management of Atrial Fibrillation
Medications have initially been used to treat AF such as anti-arrhythmic drugs that con rhythm. Rate control medications that slow the heart rate down. Anticoagulant or blood thinner to prevent clots and strokes.
This is considered when medical therapy does not effectively control or correct AF, or medications are not tolerated. Also, when anticoagulants cannot be taken such as warfarin or coumadin and or blood clots including stroke occur.
Surgical treatment for atrial fibrillation also may be considered when surgery is needed to treat a coexisting heart condition, such as valve or coronary artery disease.
Determining if surgical treatment is appropriate
e evaluation will be performed including;
A review of your medical history, Echocardiogram (Echo), complete physical exam, holter monitor test, Electrocardiogram (ECG)or other tests as needed. After the evaluation, the surgeon will discuss your treatment options and together, but in the end, it is solely your decision. Do your research and be sure it’s the right choice for you.
Who is a Candidate for Atrial Fibrillation Surgery?
Extending Treatment to virtually all patients with Atrial Fibrillation
Surgical treatment for atrial fibrillation is termed a “Maze” procedure or ablation; other commonly used terms include “mini-Maze” or pulmonary vein isolation. Results are obtained by using less invasive approaches to perform a procedure that closely resembles the classic Maze procedure. Patients considered for surgical ablation fall into two groups:
Patients with isolated AF and patients with AF who require heat surgery for other reasons most commonly to treat coronary artery disease or valvular heart disease.
Minimally Invasive Surgery
Patients with isolated Atrial Fibrillation
Currently, most patients with atrial fibrillation are candidates for minimally invasive surgical ablation. The maze procedure is the surgical ablation approach with the greatest long-term success in treating AF.
The maze procedure includes creation of lines of conduction block (scar tissue) that block the abnormal impulses that cause atrial fibrillation, enabling restoration of normal sinus rhythm. The lines of conduction block are created using cryothermy (freezing) or radio frequency energy.
Surgical ablation also includes exclusion of the left atrial appendage, the primary source of strokes in patients with atrial fibrillation. The success rate is approximately 80% to 90%, varying with patient characteristics.
Patients with Atrial Fibrillation Who Require Heart Surgery
AF is common in patients who require heart surgery for the following reasons;
Mitral valve surgery, aortic valve surgery, coronary artery bypass grafting, and other surgical procedures. Untreated atrial fibrillation in such patients increases mortality rates. Patients with a history of AF will be treated during these types of cardiac surgery.
When patients with AF have valve or bypass surgery, surgeons create a classic Maze lesion set on the heart using either radio frequency energy or cryothermy. This generally adds 15 minutes to the operative procedure and does not increase operative risk. Sinus rhythm is restored in 75% to 85% of patients, depending upon patient characteristics.
What happens during the surgery?
During minimally invasive surgery
The surgeon views the epicardial (outer) surface of the heart using an endoscope. Specialized instruments are used to isolate the pulmonary veins and create the other lines of conduction block. Unlike traditional heart surgery, there is no large chest wall incision. Therefore, recovery time is typically 3-6 weeks.
Because the surgeon can view the outside of the heart, the risk of pulmonary vein stenosis is nearly eliminated. In addition, no catheters are introduced into the left side of the beating heart, reducing the risk of blood clots and strokes.
The left atrial appendage is a small, ear-shaped tissue flap located in the left atrium. This tissue is a common source of blood clots in patients who have atrial fibrillation. During surgical procedures to treat atrial fibrillation, the left atrial appendage is either excluded or removed, reducing the risk of late stroke.
A small number of patients (about six percent) require a pacemaker after surgery due to an underlying rhythm, such as sick sinus syndrome or heart block, which previously was undetected.
Improvements in surgical techniques over the years have produced successful results in most patients:
Results are: rapid recovery from minimally invasive ablation, long term freedom from AF, decreased symptoms, decreased atrial (top chamber of the heart) size in those with enlarged atria pre-surgery, particularly patients who undergo Maze procedure with mitral valve repair procedure.
Inherited arrhythmia disorders
arrhythmia disorders include several genetic conditions that place otherwise healthy individuals at risk for sudden cardiac death.
Due to the fact that inherited arrhythmia is passed down from parents to children, a family-centered approach to care is essential.
The Inherited Arrhythmia can be addressed through pediatric and adult cardiologists who specialize in diagnosing and treating abnormal heart rhythms. Genetic counselors are also involved in the patient’s care.
“The sad part about all of what you Now have to go through is… it could’ve been prevented. Diet and exercise are key to staving off Atrial Fibrillation and most heart diseases.”
Are you having symptoms, or have you just been diagnosed with Atrial Fibrillation?
Have you had an ablation?
Maybe you’ve had a pacemaker implant?
I’d like to hear your story, or if you just have a question or comment, please feel free to leave them below.
Wishing you all the Best, Sherry