Additional Surgical Procedures
Treating Atrial Fibrillation with Surgery
What are the remaining options used to treat atrial fibrillation, and how is the decision usually made?
Medicines to treat rapid and irregular heartbeats work for many people. But they don’t work for everyone, and they may cause side effects in some people. Electrical cardioversion and catheter ablation procedures also help a number of AFib patients to reach important treatment goals and manage symptoms to a satisfactory level.
However, in many people, the atrial fibrillation continues to return despite repeated treatment attempts. This can be a very frightening and frustrating situation for many people who would like to get the problem under control.
What are the more in-depth surgical options?
There are procedures that have been very helpful and have provided long-term success to others who have recurring problems with AFib. Here are some brief descriptions of these procedures with additional information provided at the StopAfib.org links below.
An Open-Heart Ablation with Maze-like Atrial Repairs
Maze heart surgery is a complex process that may provide a cure for atrial fibrillation by interrupting the electrical signals causing the irregular heart rhythms. These procedures can restore a regular heart rhythm following recovery. For a small percentage of patients, the need for a pacemaker will arise during or after the procedure.
- Cox maze (III) procedure is an open-heart surgery done by a cardiothoracic surgeon using a traditional "cut-and-sew" procedure to scar the tissue. It is considered the most effective for long-term relief of atrial fibrillation symptoms but is highly complex and rarely done today. Today’s patients who need surgery are more likely to be offered the Cox Maze IV (called simply a maze procedure) or a mini maze as described below.
- Maze procedure (Cox maze IV) is a surgical ablation done by a cardiothoracic surgeon. It uses the same open-heart procedure as Cox maze III, but uses an energy source to scar the tissue rather than to remove it or scar it with traditional “cut-and-sew” techniques. This procedure may be done as a standalone procedure, but is more typically done along with other heart surgery, such as a valve repair or a bypass, which is called “concomitant surgery”.
- Mini-maze procedure is a minimally-invasive surgical ablation that also uses an energy source to scar the tissue, like the Maze procedure above. However, the mini-maze doesn't require the surgeon to fully open the chest, so it typically offers a shorter recovery time. The sternum remains in-tact, and the procedure is done using video-guided technology and robotically-assisted surgical tools. It is less invasive than the other surgery options and is slightly more invasive than catheter ablation.
The journey to finding a long-term workable solution for atrial fibrillation can be complex for both patients and providers. Through effective teamwork and a positive, persistent attitude, we hope your commitment to wellness pays off with a long-term solution