New Surgery for Atrial Fibrillation Shows Promise

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A minimally invasive surgical procedure to treat atrial fibrillation—the most common form of heart rhythm abnormality—works as well as the traditional surgical treatment and takes half the time.

That’s the finding of a study by researchers at Washington University School of Medicine in St. Louis.

"Our findings show that this technique is much easier to perform but works just as well as the move invasive approach,” principal investigator Dr. Ralph J. Damiano, chief of surgery, said in a prepared statement. “This is very good news because it means more surgeons can perform the procedure and it will be applicable to virtually all patients with this irregular rhythm.”

The traditional surgical approach is called the Cox maze procedure. Surgeons make small incisions in the atria, the heart’s two upper chambers. These incisions create scar tissue that act as barriers to abnormal electrical signals that cause atrial fibrillation.

This surgery is technically difficult and not all patients are healthy enough to endure the operation. The heart has to be temporarily stopped during the surgery and blood circulation has to be done by a heart-lung machine during that time.

Damiano and his team developed an alternative form of the Cox maze procedure that uses two electrodes. These electrodes pass a current through a targeted area of the heart, heating and killing a thin band of tissue. This creates scar tissue that blocks abnormal electrical signals.

This new method was tested on 40 patients and the success rate was similar to that of the traditional surgery. The new method took an average of 54 minutes, compared to an average of 93 minutes for the traditional method.

“Shorter operative times are important for patient safety and outcome. If we shorten the procedure, it decreases the time we need to keep patients on the heart-lung machine. We are working in the laboratory on an approach that someday will allow us to perform atrial fibrillation surgery on the beating heart,” Damiano said.

The findings appear in the October issue of the Journal of Thoracic and Cardiovascular Surgery.

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