Medical Q&As

Atrial fibrillation - surgical treatment?

Is there an operation available to stop atrial fibrillation?

Atrial fibrillation is a particular form of cardiac rhythm disturbance. Up to recent times it could only be treated with drugs or cardioversion, which is a form of electrical shock treatment to the heart. A surgical procedure has now been developed to treat the condition but I am not aware if this treatment is yet available in Ireland. The procedure is called MAZE and involves making several strategic incisions in both the right and left atrium, which are two of the four pumping chambers of the heart. The resulting scars from these incisions disrupt the errant pathway of electrical conduction that is a feature of atrial fibrillation. The name MAZE is derived from the concept of an actual maze that contains several blind alleys but only one route to freedom. In other words the surgical procedure cuts off the blind alleys and channels the electrical impulse through a direct route. The procedure involves a direct surgical approach through the breastbone, which is the same route that is taken with open-heart surgery. The surgeon needs to work on a non-beating heart in order to make the necessary incisions therefore the person needs to be maintained on a heart-lung machine for the duration of that stage of the procedure. The procedure lasts approximately four hours from initial opening to completion of stitching up with approximately one hour of that time being taken up with the actual strategic incising of sections of the atria. Since this procedure is a relatively major surgical undertaking it would not be suitable for all patients with atrial fibrillation. Given the amount of time and money involved in this procedure it is likely that medical treatment of atrial fibrillation will remain the commonest option for the foreseeable future.