The High-Tech Heart: New Procedure - Can Cure Atrial Fibrillation
Atrial fibrillation (AF) is the most common type of irregular heart beat in the
U.S. It affects approximately 2.5 million American patients. Patients with AF
have a seven times greater chance of stroke than patients who do not have the
condition. AF is the second leading cause of hospitalization for heart
conditions. Heart failure is the first cause, and AF is often a leading cause of
The medications that are available for AF (anti-clotting drugs) can cause
bleeding problems, and it’s necessary to take them on a life-long basis. An
operation that is sometimes performed to treat AF (catheter ablation) takes many
hours to perform and may require a permanent pacemaker. This procedure can
sometimes cause serious complications, such as bleeding in the pericardium.
There’s a new procedure that’s becoming available that offers hope of a cure
to many people with AF. It’s called Mini-Maze surgery, and so far, it’s been
successful in about 80 percent of cases.
During the surgery, doctors make a small incision between the ribs. They then
insert the Mini-Maze instrument into the chest cavity. A small fiber optic
camera guides them as they grip the top of the atrium—where the abnormal rhythm
impulses begin—with the Mini-Maze tool. The tool destroys a small amount of
tissue so that it can no longer conduct electrical activity. The rest of the
area can beat normally.
The mini-Maze operation takes about three hours. Recovery is not as painful
because surgeons don’t have to spread the ribs apart during the procedure. Most
patients leave the hospital after three or four days.
S. Holt. Journal of the American Medical Association,
1998;280:2001-2007; The Natural Way to a Healthy Heart, M. Evans and
Company, Inc., New York, New York, 1999. American Heart Association; National
Heart, Lung and Blood Institute