Back to Education
Welcome to the Nebraska Heart Institute "What's New" informational section. The Nebraska Heart Institute's surgical team provides
this month's information.
What is "Atrial Fibrillation"?
The upper chambers of the heart (atria) send out signals to the heart's lower chambers (ventricles) and this is how the heart forms a normal beat.
This normal beat allows blood to pump sufficiently throughout your body and is a crucial part of normal circulation.
Sometimes the atria sends out too many signals or "erratic" signals resulting in the atria not working in conjunction or rhythm
with the ventricles. Atrial Fib prevents the top and the bottom parts of the heart from working together.
The circulation of blood throughout your body may be reduced as much as 20-30 percent. This is why you may feel tired or weak.
Atrial Fibrillation (AF) is widely known as the most common sustained cardiac arrhythmia. AF affects an estimated 2.5 million patients in the U.S.
with approximately 300,000 new cases diagnosed annually. It's predicted that 5.6 million patients will be diagnosed with AF by the year 2050. The risk of
stroke in patients with AF is estimated at 7 times greater than patients without AF. Atrial Fibrillation is second only to heart failure in terms of cardiac related
hospitalizations.
What Causes Atrial Fibrillation?
Atrial Fibrillation affects millions of people. Most are over the age of 65 years and have other underlying conditions that put them at a higher
risk such as high blood pressure, hyperthyroidism, lung problems, diabetes, alcoholism, or drinking high levels of caffeine. It may in some
cases occur in otherwise healthy individuals.
What are the Symptoms of Atrial Fibrillation?
Symptoms include:
- Heart palpitations (racing feeling in your chest)
- Tiredness
- Dizziness
- Shortness of breath
- Discomfort in your chest
Some people have no symptoms at all.
Why Should Atrial Fibrillation Be Treated?
Restoring your normal heart rhythm, controlling your heart rate and preventing clots from forming are the goals of treament. You may be on
medication to maintain normal heart rhythm, these are called anti-arrhythmics. Controlling heart rate is usually done with beta-blockers
or calcium channel blockers. Additionally, blood-thinners such as coumadin are used to prevent clots and strokes. These are the medical options;
however, these do not work all the time and many patients have continued symptoms and are unable to tolerate the medications. Fortunately, there
are other new and innovative ways to surgically treat Atrial Fibrillation.
Treating Atrial Fibrillation with Surgery.
You may benefit from surgery to cure your Atrial Fibrillation if:
- You have symptoms and your medications aren't working
- You are at risk for forming clots and stroke
- You are having a heart operation already
It may be time to consider a surgical option often referred to as the MAZE procedure, or modified MAZE or surgical ablation.
Surgeons at the Nebraska Heart Institute have performed over 180 surgical procedures for AF. Recently, a new minimally
invasive technique has been used successfully for the treatment of AF. Benefits include no steral incision, less blood loss, and quicker recovery.
A major part of the surgical procedure, for AF, includes removal of the left atrial appendage, which is the likely source of stroke in
patients with AF. Removing the appendage dramatically reduces the risk of stroke and may allow discontinuation or reducing the need for coumadin.
The MAZE procedure is a surgical intervention that cures Atrial Fibrillation by interrupting these extra electrical beats that are
fired from the atria of the heart. Traditionally, the MAZE procedure, done by cutting and sewing of the heart, has been
very successful. Recently, alternative energy sources have been used to replace cutting and sewing of incisions with linear lines of
ablation (lesions) to stop the abnormal impulses. The surgeon uses a highly selective and safe device which creates lesions in the top
portion of the heart to stop the conduction of the extra beats while channeling the normal impulse from the top of the heart to the bottom
to form a normal beat. The scar tissue forms where the lesions were made and the abnormal beats are now unable to form. Your heart will
beat normally again and provide the body with the blood supply it needs.
If you are already having an open heart surgery procedure and you are a candidate for surgical treatment of Atrial Fibrillation, the
surgeon will be able to access your heart through the same incision.
If you are not having an open heart surgery procedure but may be a candidate for surgical treatment of Atrial Fibrillation, you may be a
candidate for Minimally Invasive Surgery where your operation will be done with small incisions and without the heart-lung machine to
cure your Atrial Fibrillation.
What are the Side Effects and Benefits of Having Surgical Treatment?
You have a very good chance of having short-term Atrial Fibrillation right after heart surgery. This is very common and will likely
cease in about 3 months as the heart heals. During this time, you will continue to be on medications until your heart is fully healed.
The MAZE procedure, when successful, maintains the normal regular rhythm of the heart and prevents stroke. Additionally, long-term medications
such as coumadin may no longer be required.
You and your surgeon will make the final decision if you are a candidate for surgical treatment of Atrial Fibrillation. Your doctor will discuss
the risks of this surgery as well as any questions you may have. You will also have close follow up after your surgery and access to a nurse for
any questions or concerns.
For more information, contact the Nebraska Heart Institute at (402) 489-6555. |
