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Home > Cardiac Surgery > Surgical Treatment for Atrial Fibrillation

Surgical Treatment of Atrial Fibrillation

Atrial Fibrillation (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.
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