Ablation Therapy for Atrial Fibrillation

Atrial Fibrillation is the most common type of disorder of your heart rate or rhythm. It occurs when disorganized electrical signals cause the atria (heart's two upper chambers) to contract very rapidly and irregularly. As a result, the blood is not pumped completely into the ventricles (heart's two lower chambers) and collects in the atria. The atria and ventricles therefore do not contract in a coordinated manner, resulting in either too much or not enough blood being sent from the heart to the body.

People with atrial fibrillation may not experience any symptoms. In some people, it may cause chest pain, heart failure, and increased risk of stroke.

Treatment of atrial fibrillation involves medications and certain medical procedures to restore a normal heart rhythm. Blood thinners may be prescribed to reduce the risk of blood clots and stroke. Cardioversion, a procedure where an electrical shock is delivered to your heart to restore its normal rhythm, may also be performed. If medications or cardioversion does not work to control atrial fibrillation, ablation therapy is recommended.

Ablation therapy aims to create scar tissue near the site of the origin of the abnormal electrical impulses to terminate them and prevent them from spreading. Ablation can be performed either surgically or nonsurgically depending on the type of arrhythmia (abnormal heart rhythm) and the presence of other cardiac problems.

Nonsurgical ablation: In this procedure, a special catheter is inserted through veins in the groin and guided into the specific area of the heart to ablate the abnormal electrical signals. Either radiofrequency or cryothermy may be used for ablation.

Surgical ablation: This is frequently combined with other heart surgeries such as mitral valve repair and coronary heart surgery. It involves either of the following surgical procedures:

The Maze Procedure: This procedure involves a traditional open heart surgery where small cuts are made in the left and right atrium to disrupt the conduction of abnormal impulses. The resulting scar tissue then blocks the abnormal impulses from spreading. This surgery is done through an open incision, with the heart stopped and the patient on bypass machine.

Mini Maze Procedure: This is a minimally invasive approach to the Maze procedure, in which surgery is done through smaller incisions. Endoscopes are utilized to view the surgical area. It is done on a beating heart and does not require the use of heart lung machine, and can be performed with the use of robotic technology.

As the surgery is performed through smaller incisions, the mini maze procedure minimizes trauma and provides benefits of smaller scars, decreased risk of infection, less bleeding, less post-operative pain, faster recovery, shorter hospital stay and quicker return to daily normal activities. No use of heart–lung machine provides additional benefits that include reduced risk of stroke, reduced risk of renal failure and fewer cognitive side effects after the surgery.

The modified Maze procedure: A single incision in the left atrium is made to gain access to the heart to block the abnormal electrical impulses and to correct electrical conduction pathway. Special catheters, utilizing any of the four energy sources: radiofrequency, microwave, laser or cryothermy, are used to perform ablation.

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