Atrial fibrillation, or AFib, happens when the upper chambers of the heart (the atria) beat irregularly instead of beating effectively to move blood into the ventricles. This irregular heartbeat, or arrhythmia, can lead to blood clots, stroke, heart failure and other heart-related complications.
What are the surgical treatments for AFib?
The two most common surgical treatments for AFib are the Maze (performed during open heart surgery or a minimally invasive approach) and Convergent Ablation Procedures. A third option is ablation during minimally invasive valve surgery. CTVS board-certified cardiothoracic surgeon Dr. Faraz Kerendi says that treatments are effective, but the severity of your condition, along with how you may have responded to previous treatments, often dictates which treatment is right for you.
“The Maze Procedure is where we surgically create a pattern of scar tissue (a maze) in the upper chambers of the heart. Scar tissue doesn’t carry electricity, so the maze interferes with the impulses that cause AFib,” explains Dr. Kerendi.
What are the benefits of the Maze Procedure?
- Performed during open heart surgery concurrently with other open procedures (such as bypass surgery, valve surgery, etc.).
- Restores regular heartbeat and normal sinus rhythm.
- Reduces the risk of stroke and prevents the development of heart failure.
- May allow patients to stop taking rhythm medications and blood thinners.
During the Convergent procedure, surgeons use radiofrequency to block irregular electrical signals by creating lesions or scar tissue. “It’s good for those who have tried other treatments without success,” says Dr. Kerendi. “In a recent clinical trial, this combined procedure was proven to have increased efficacy for the treatment of persistent atrial fibrillation as compared to catheter ablation only.”
What are the benefits of the Convergent Procedure and Totally Thoracoscopic (TT) maze?
- Is minimally-invasive compared to other surgeries/treatments.
- Provides for a shorter hospital stay and recovery time.
- Potentially decreases the number of follow-up treatments needed.
According to Dr. Kerendi, “many patients who have valvular heart disease, particularly mitral valve prolapse/regurgitation may ultimately develop AFib.” Both of these disease processes can often be treated with a minimally invasive approach.
What are the benefits of ablation during minimally invasive mitral valve surgery?
- Treated with a minimally invasive approach.
- Incision is made between the ribs versus the breastbone
- Reduces the risk of stroke and heart failure.
- Potentially decrease the need for medications.