What are the Treatment Options for AFib? Part 2, Surgery

While AFib or atrial fibrillation can be a serious condition, often it does not cause problems and, in some cases, individuals may not even know they have it. More than two million people in the US have AFib, and many of these cases do not require medical attention. Sometimes, however, when the ‘chest fluttering’ is pronounced, or a person feels ‘pounding’ in their chest, a racing heart, or a feeling as though their heart is ‘flip-flopping,’ the condition should be evaluated by a medical professional. If you suspect you may have AFib, you should contact the Atrial Fibrillation Center Of America medical clinic for an appointment to visit with one of our heart arrhythmia specialists.

Often AFib can be managed by using medications to control the heart rhythm and blood thinners to reduce the risks of strokes which may accompany the condition. AFib is caused by disorganization of the heart’s electrical signals which results in irregular heartbeat and reduced blood flow throughout the body. In some cases, however, medications are not sufficient to control AFib, and surgical procedures might be recommended.

The surgical approaches to treating AFib center around disrupting the links or pathways between the source of the disorganized electrical signals (in the upper chambers of the heart) and the receiving sites for the signals in the ventricles (the lower chambers). The problems arise when these signals are sent in disorganized and erratic patterns causing incorrect contractions of the ventricles.

Based on an evaluation by a physician, the patient’s condition, and the length of time the AFib has been present, a surgical procedure may be recommended. A primary cause of AFib is the combination of healthy cells and random cells sending out mixed groups of electrical signals to the heart in erratic patterns. These disorganized signals result in irregular heartbeat and AFib. Surgical approaches have been developed to either isolate or destroy the random cells. The following three procedures are frequently used.

  • Catheter Ablation: This procedure involves inserting long, thin catheters with special electrode tips attached at the ends into the heart. Depending on the approach selected the electrode tip heats, using radio frequencies, or cools, using cryotherapy. Either method destroys and isolates the cells sending random, false signals. The scar tissue that develops at the surgical site disrupts the flow of these false electrical signals and allows the heart to return to its normal rhythm.
  • Atrioventricular (AV) Node Ablation: This procedure involves destroying a small area of tissue in the heart to interrupt and block the disorganized electrical signals. The signals which control the rhythm of the heart originate in the upper chamber of the heart or the atria. These signals travel along certain pathways from the upper to the lower chambers of the heart. An AV node ablation uses a radio frequency cardiac catheterization procedure to heat and destroy cells along the signal pathways. The scar tissue and cell destruction block the flow of the faulty signals. To maintain and control the rhythm of the heart, a pacemaker is implanted which becomes the source of the electrical signals needed for the heart to function.
  • Maze Procedure: In some situations, a procedure called a ‘Maze Procedure’ is performed to interrupt and re-route the faulty electrical signals coming from the atria. During this procedure, which is often performed during open heart surgery, a maze-like pattern of small incisions is made along the electrical pathway leading from the atria to the ventricle. As with other surgical methods, the scar tissue that results from the incisions causes interruptions in the flow of the signals and allows the heart to return to a normal rhythm. This procedure is often recommended when the patient is having open heart surgery for other reasons, such as heart valve repair.

Many factors are taken into consideration to determine the proper approach to managing any patient’s AFib. It is essential that individuals with AFib or that may be concerned they have AFib seek medical advice. Atrial Fibrillation Center Of America specializes in diagnosing, treating, and managing AFib and other heart arrhythmias. If you feel you may have an arrhythmia, please call our office at (832) 478-5067. Our professional staff will be glad to set an appointment and answer your questions. You’ll be glad you called.

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