Cardiac Surgery >
Surgical Treatment for Atrial Fibrillation
Surgical Treatment of
(AF) is an abnormal heart rhythm that commonly occurs in patients after
open heart surgery. It can also occur in patients spontaneously. It is
a condition in which the upper chambers of the heart fibrillates or
quivers instead of contracting normally. This quivering of the upper
chambers of the heart can cause a variety of symptoms. The majority of
patients are either asymptomatic or have only occasional palpitations.
However, the condition can be life threatening. If the fibrillation of
the upper chambers of the heart is transmitted to the lower chambers
(ventricles), the patients heart rate can become too fast to maintain
adequate output of blood by the heart. When this occurs the patients
will quite often have much more dramatic symptoms. They can include
shortness of breath, fatigue and loss of strength, diaphoresis,
dizziness, and even passing out (syncope). In cases of recurrent and/or
chronic AF, blood clots can form in the upper chambers of the heart and
lead to strokes. Quite often patients will be treated with two types of
medications. One for controlling the abnormal heart rhythm, and another
for prevention of blood clot formation. The medication commonly used
for the later is coumadin (AKA warfarin).
In the late 1980’s a
surgical procedure was developed to convert AF to normal sinus rhythm.
This procedure was/is known as the “Maze” procedure. Unlike other
medical therapy for AF that works to control the abnormal rhythm with
life long medication, the Maze procedure actually converts the abnormal
heart rhythm back into a normal sinus rhythm. This takes away the need
for future life long medications. Phoenix Cardiac Surgery has been
performing this operation since 2001 in combination with other open
heart operations. In patients who are undergoing open heart surgery for
conditions such as coronary artery disease, and valvular heart disease,
if they have a history of AF, the Maze procedure would typically be
added to their planned operation. The Maze procedure added very little
time to the operation, and had the potential to help tremendously to the
overall health of the patient.
In March 2004,
surgeons of Phoenix Cardiac Surgery performed their first
minimally invasive Maze procedure. This
procedure is done for patients with lone AF. This means that they
have no other indications for heart surgery other than AF. The
procedure is still done under general anesthesia, but instead of
utilizing a typical sternotomy approach (incision in the middle of the
chest with fracturing of the breast bone), it can be done through very
small (less than 1 inch) incisions on the side of the chest.
Surgeons affiliated with Phoenix Cardiac Surgery are regional leaders in
this new approach for the treatment of AF and participate in the
training of other heart surgeons in the Southwest of America on this new
approach. The procedure is typically performed with minimal discomfort
compared to the traditional approach, and has a high success rate.
Interested parties should contact our office to speak to one of our
surgeons who would be happy to answer any questions for you.