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

Recent Discussions From The Providers Office Forum
Marcolandin avatar

Does anyone know a great doctor for afib in Houston, everyone tells me to go to st. Luke’s hospital but I would like something more specific. I had an ablation last year and I still go into afib everyday. I even was placed on more meds. I’m 34 and I know there is no “cure” but going into afib everyday keeps me from working out and enjoying trips with friends and family. Thank you for the help

Geronimo avatar

I've had Afib for over a year and during that time have had an ablation and 10+ Cardioversions. I went back into AFib 3 weeks ago and couldn't be cardioverted out this time so question on the table is if I should go back for the 2nd Ablation. I'm wondering if I should just live with the symptoms or go for the 2nd ablation. The past year hasn't been fun living in constant fear of when/if I will go back into Afib, looking out for possible triggers (no canfine, no alchohol, limited excercise, etc.)  not to mention I hate being Cardioverted every 40-90 days. It seems like I might be better off just accepting my persistent Afib with the associated sysmptoms and living my life as is. Has anyone else gone through this thought process? Any idea of what the long term impact is if I take this course of action?

Deb M avatar

I am going into the hospital next Wednesday for "tikosyn load". My doctor's office is not very forthcoming with information. Can anyone tell me what to expect? How is the load done and monitored? Is the load constant through IV or only at particular times? Do you have to actually lay in a bed for 3 days or can you get up and move around? Can you shower? What should you take to the hospital with you? Were you able to have visitors? How long before you can resume normal activies when you return home? Has being on this medication changed your life style?I would appreciate any advice anyone has. Thank you.

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