Interventional Treatment of Atrial Fibrillation

Atrial Fibrillation (also referred to as AF or Afib) is the most common type of irregular heartbeat. It is found in about 2.2 million Americans. Its frequency increases with age. If you have AF, the electrical impulse does not travel in an orderly fashion through the atria. Instead, many impulses begin simultaneously and spread through the atria and compete for a chance to travel through the AV node.

The firing of these impulses results in a very rapid and disorganized heartbeat. The rate of impulses through the atria can range from 300 to 600 beats per minute. Luckily, the AV node limits the number of impulses it allows to travel to the ventricles. As a result, the pulse rate is often less than 150 beats per minute, but this is often fast enough to cause symptoms.

Currently, most patients with atrial fibrillation are candidates for minimally invasive surgery. Our approaches here at Holy Cross Hospital include robotically assisted and keyhole surgery. Currently, advanced surgical robotics can be used to create all of the lesions of the classic maze procedure; the maze procedure is the surgical approach with the greatest long-term success in treating atrial fibrillation. The robotically-assisted maze procedure includes creation of lines of conduction block (scar tissue) that block the abnormal impulses that cause atrial fibrillation, enabling restoration of normal sinus rhythm. The lines of conduction block are created using cryothermy (freezing). Robotically assisted surgical ablation also includes exclusion of the left atrial appendage, the primary source of strokes in patients with atrial fibrillation.

The robotically assisted maze procedure from the Jim Moran Heart and Vascular Center is appropriate for patients with highly symptomatic atrial fibrillation, patients in whom catheter ablation has failed, and patients who have a history of stroke or other blood clots. The success rate is approximately greater than 90%, varying with patient characteristics.

Watch a video about Atrial Fibrillation and Electrophysiology at Holy Cross Hospital.