What can I Expect During Atrial Fibrillation Surgery?

Atrial fibrillation surgery is a type of heart operation aimed at reducing or eliminating the negative effects that occur from the condition known as atrial fibrillation, which is a type of irregular heart beat. It is an aggressive procedure generally attempted following the failure of more conservative measures, such as prescription drugs, to rectify the problem. Known specifically as the Maze procedure, atrial fibrillation surgery is a minimally invasive inpatient operation with a two to three week recovery period.

In non-medical terms, atrial fibrillation occurs when the strong, even electrical pulse that generates each beat of the heart becomes fragmented in its timing. This leads to weaker, irregular beats that drive less oxygen through the bloodstream. The symptoms of atrial fibrillation include light-headedness, heart palpitations, and discomfort in the chest. These symptoms are general in nature, and a proper diagnosis must be obtained through advanced tests like an electrocardiogram.

Once diagnosed, treatments are started to try and regulate the heartbeat. Prescriptions are generally given for anti-coagulent medication to lower the risk of heart attack or stroke from clots. If drugs are not enough, a catheter may be inserted into the heart to try to moderate the electrical impulses. If these initial treatments don't work or if there are extenuating factors, such as a drug allergy, atrial fibrillation surgery is recommended.

Before atrial fibrillation surgery, the patient is put under general anesthesia, so there is no pain or sensation during the procedure. Typically, the Maze procedure is arthroscopic or undertaken with robot-guided instruments. Either method minimizes the size of the incisions needed, lessening recovery time and the risk of complications.

The idea behind atrial fibrillation surgery is to create scar tissue that blocks the abnormal electrical impulses. This is achieved by cutting tiny lesions, known as conduction blocks, on the outer surface of the heart. The scar tissue forms as the lesions heal and block all but the intended pulses. During the surgery, the pulmonary veins are isolated, and a small piece of tissue known as the left atrial appendage is often removed to prevent clots from forming. Clots are a common problem for those with atrial fibrillation.

Unlike more complex heart operations, atrial fibrillation surgery does not require a large opening to be made through the ribcage. This alone greatly improves the chances and speed of recovery. Any time the heart has to be operated on is serious, however, and as such surgeons may often try to carry out a Maze procedure when already performing other procedures such as a valve surgery or bypass graft.