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Arrhythmia Surgery | Baylor Dallas

Arrhythmia Surgery

An arrhythmia is an abnormal heart rhythm, the result of a problem with the heart's electrical system used to regulate a healthy heartbeat. Your heart may beat at an irregular pace, or too fast or too slow. Although some arrhythmias have no complications, more serious conditions can result in heart failure, stroke, or even cardiac arrest.

The multidisciplinary health care team at the Baylor Heart and Vascular Hospital Center for Complex Arrhythmias (CCA) specializes in the diagnosis and treatment of abnormal heart rhythms. Patient treatment options include medication therapy, catheter based procedures, and surgery.

One type of surgery requiring general anesthesia is surgical ablation. In this procedure, the surgeon opens your chest to reach your heart and eradicates or removes the tissue causing the arrhythmia. Surgery is usually performed when other treatment options have been unsuccessful.

Another surgical treatment option for a specialized type of arrhythmia, atrial fibrillation, is the Maze procedure.

Atrial fibrillation surgery/Maze procedure

Atrial fibrillation is an arrhythmia, a disturbance in the heart's rate or rhythm. Ordinarily the atria, the heart's upper chambers, and the ventricles, the lower chambers of the heart, contract to move blood steadily through the heart. In atrial fibrillation (also known as AF or A-fib) the electrical signal that causes the atria to contract vibrates in an uncoordinated way. When this occurs the atria may fire more than 400 times per minute without contracting. Atrial fibrillation may also affect the ventricles, leading to an uneven, fast heart rate.

Left untreated, a-fib can lead to cardiomyopathy (an enlarged heart), heart failure, or stroke. Treatment for a-fib focuses on eliminating the factors that may be causing the condition including medication and surgery.

One surgical treatment for a-fib is the Maze procedure. Using this approach, the surgeon uses small incisions or an energy source to create scar tissue to block the abnormal electric signals associated with a-fib. The Maze procedure is a treatment option for patients when medication does not control a-fib, when patients do not tolerate a-fib medication, or if the patient has experienced a stroke.

The Maze procedure includes several variations:

  • Cox-Maze III is open heart surgery. The surgeon makes incisions in the atria in an intricate pattern resembling a maze and then immediately sutures (sews) these incisions. Scar tissue forms as the incisions heal.
  • Cox-Maze IV, like Cox-Maze III, is an open chest procedure using surgical ablation. A physician uses radiofrequency, cold (cryo), ultrasound, or microwave energy to create the scar tissue instead of creating incisions in the heart tissue.
  • Mini Maze or thoracoscopic Maze is a minimally-invasive procedure. The physician inserts thin surgical tools and fiber-optic cameras into small incisions in the chest and then uses energy-based techniques to create the scar tissue.

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