Surgical Ablation of Atrial Fibrillation

Facts on Atrial Fibrillation

  • Atrial fibrillation is the most common type of arrhythmia (abnormal heart rhythm).
  • When atrial fibrillation and other arrhythmias occur, the electrical activity of the heart is disorganized, causing an irregular heartbeat. The irregular heartbeat disrupts the flow of blood through the heart.
  • Treatment of atrial fibrillation represents a significant health care burden. The estimated cost of the treatment of atrial fibrillation in 2005 was $6.65 billion per year, including the costs of hospitalization, physician care, and medications.
  • The incidence of atrial fibrillation increases with age. The median age for patients with atrial fibrillation is 66.8 years for men and 74.6 years for women.
  • The mortality rate from atrial fibrillation as either the primary or an underlying cause of death has been increasing for more than two decades.

Risk factors for atrial fibrillation include high blood pressure, heart failure, diabetes, advanced age, hyperthyroidism, and heart disease.

Atrial fibrillation can lead to:

  • Blood clots
  • Stroke
  • Heart attack
  • Heart failure
  • Chronic fatigue
  • Death

Surgical Treatment of Atrial Fibrillation

The gold standard surgical procedure for treatment of atrial fibrillation was pioneered by Dr. James L. Cox at Washington University and is called the MAZE procedure. The fourth generation of that operation, referred to as the Cox MAZE IV, involves the creation of precise scars in the atrial chambers of the heart to block the conduction of the erratic electrical signals of atrial fibrillation. These scars redirect the erratic electrical impulses of atrial fibrillation to follow a normal electrical pathway through the heart. The operation has been proven to cure atrial fibrillation with as high as a 90% success rate, and reduces the risk of stroke and other complications related to atrial fibrillation. Our surgeons use a technique called radiofrequency ablation to create scars in the very same pattern described by Dr. Cox  in the MAZE IV procedure, which has proven to be the most successful and effective method of eliminating atrial fibrillation.

This operation is frequently performed in conjunction with other heart surgeries, such as mitral valve repair or coronary artery bypass, but is also performed as a stand-alone procedure for patients with atrial fibrillation.

Surgical radiofrequency ablation for atrial fibrillation offers the following benefits:

  • 75 to 90 percent cure rate of atrial fibrillation
  • Reduction in risk of blood clots and stroke
  • Fewer or no symptoms related to abnormal heart rhythms
  • Reduction or discontinuation of blood thinners such as Coumadin
  • Reduction or discontinuation of anti-arrhythmic drugs such as Amiodarone
  • Most patients who have had the procedure report an ability to exercise more frequently and for longer periods of time
  • In some cases, the procedure will reduce the size of the atria, therefore lessening the risk for other complications, such as heart failure

How do you know if you are a candidate for surgical treatment of atrial fibrillation?

Radiofrequency ablation for atrial fibrillation is an option if:

  • You have chronic atrial fibrillation
  • Your atrial fibrillation is not well controlled by medication
  • You have intermittent atrial fibrillation that is disabling
  • You require another type of heart surgery procedure, such as mitral valve surgery or coronary artery bypass surgery
  • You have a history of stroke or cannot take Coumadin