Atrial fibrillation is an irregular heart rhythm (arrhythmia) where the upper chambers of the heart (right and left atria) quiver instead of effectively beating. Though the condition itself is not fatal, it can lead to blood clots, stroke, and heart failure. It is a common disorder that affects 2.7 million Americans.
The first line treatment for atrial fibrillation is medical therapy, typically managed by a patient's cardiologist. The typical approach entails two key steps: restoring a normal heart rate and rhythm and managing the risk for stroke. Atrial fibrillation treatment focuses on restoring your normal heart rate and rhythm to improve common symptoms such as fatigue, shortness of breath and a racing heart. Management of atrial fibrillation also involves minimizing the risk of clot formation in the heart with blood thinning medications. Clots within the heart can lead to stroke.
There are more invasive treatments available for treating atrial fibrillation in cases where medical therapy is not successful. These are performed by cardiac electrophysiologists, cardiac surgeons, and sometimes both. Catheter ablation procedures are performed in the cardiac catheterization lab by electrophysiologists. Small plastic tubes called catheters are inserted into the body and used to delivery energy to destroy cells responsible for atrial fibrillation. Types of ablation for atrial fibrillation include: Cryoablation (using extreme cold), FIRM ablation (mapping technology) and Radiofrequency ablation (using heat).
The Maze procedure is an operation performed for atrial fibrillation in the operating room by cardiac surgeons. This can be performed as a stand-alone procedure or in combination with other open-heart surgeries (i.e. bypass surgery, valve surgery). The Maze procedure can be done through an open chest or a minimally invasive procedure. A number of small incisions and lesions are made on the left and right atria to form scar tissue. This scar tissue interrupts the abnormal electrical pathways that cause atrial fibrillation. The Maze procedure is useful in the multidisciplinary management of atrial fibrillation, but it is not necessary for all patients with the disease. Hybrid surgical-catheter ablation offers a new treatment option for patients with hard-to-treat atrial fibrillation. It is a combination procedure performed in the same setting by both a cardiac surgeon and an electrophysiologist. This procedure combines catheter ablation with thoracoscopic surgery, a minimally invasive chest surgery. By treating tissue both inside and outside the heart, hybrid ablation more effectively blocks the abnormal electrical signals causing the arrhythmia to provide a more permanent treatment for persistent atrial fibrillation. This innovative, collaborative approach provides better long-term outcomes.
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