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Arrhythmia Surgery

Baylor Scott & White Heart and Vascular Hospital – Dallas

An abnormal heart rhythm could be a sign of a serious condition

An arrhythmia is an abnormal heart rhythm and is the result of a problem with the heart's electrical system used to regulate a healthy heartbeat. Your heart may beat at an irregular pace, or too fast or too slow. Although some heart arrhythmias have no complications, more serious conditions can result in heart failure, stroke or even cardiac arrest.

The multidisciplinary healthcare team that participates in the Heart Rhythm Center here in Dallas specializes in the diagnosis and treatment of abnormal heart rhythms, like arrhythmia. Patient treatment options include medication therapy, catheter-based procedures and surgery.

One type of surgery that treats a heart arrhythmia and requires general anesthesia is called surgical ablation. In this procedure, the heart surgeon opens your chest to reach your heart and eradicates or removes the tissue causing the arrhythmia. Surgery is usually performed when other heart arrhythmia treatment options have been unsuccessful.

Another surgical treatment option we perform at the hospital for a specialized type of arrhythmia—atrial fibrillation—is the Maze procedure.

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Atrial fibrillation surgery/Maze procedure

 

Atrial fibrillation is an arrhythmia, a disturbance in the heart's rate or rhythm. Ordinarily, the atria (the heart's upper chambers) and the ventricles (the lower chambers of the heart) contract to move blood steadily through the heart. In atrial fibrillation (also known as AF or AFib), the electrical signal that causes the atria to contract vibrates in an uncoordinated way. When atrial fibrillation occurs, the atria may fire more than 400 times per minute without contracting. Atrial fibrillation may also affect the ventricles, leading to an uneven, fast heart rate.

Left untreated, AFib can lead to cardiomyopathy (an enlarged heart), heart failure or stroke. Treatment for AFib focuses on eliminating the factors that may cause the condition, and could include medication and surgery.

One surgical treatment for AFib is the Maze procedure. Using this approach, the heart surgeon uses small incisions or an energy source to create scar tissue to block the abnormal electric signals associated with AFib. The Maze procedure is a treatment option for patients when medication does not control AFib, when patients do not tolerate AFib medication or if the patient has experienced a stroke.

 

The Maze procedure includes several variations:

  • Cox-Maze III is open-heart surgery. The heart surgeon makes incisions in the atria in an intricate pattern resembling a maze and then immediately sutures (sews) these incisions. Scar tissue forms as the incisions heal.
  • Cox-Maze IV, like Cox-Maze III, is an open-chest procedure using surgical ablation. A physician uses radiofrequency, cold (cryo), ultrasound or microwave energy to create the scar tissue instead of creating incisions in the heart tissue.
  • Mini Maze—or thoracoscopic Maze—is a minimally invasive heart procedure. The physician inserts thin surgical tools and fiber-optic cameras into small incisions in the chest and then uses energy-based techniques to create the scar tissue to treat the arrhythmia.
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