Atrial Fibrillation Surgery

Atrial fibrillation ablation is a procedure used to treat an irregular heart rhythm (arrhythmia) that starts in the heart’s upper chambers (atria). It’s a type of cardiac ablation, which works by scarring or destroying tissue in your heart to disrupt faulty electrical signals causing arrhythmia. Atrial fibrillation ablation may be used if medications or other interventions to control an irregular heart rhythm don’t work. Rarely, it’s the first choice of treatment for atrial fibrillation. Treatment for atrial fibrillation usually improves your symptoms, such as fatigue and shortness of breath. Without treatment, atrial fibrillation tends to get worse over time.

Symptoms

Noticeable arrhythmia symptoms may include:

• A fluttering in your chest
• A racing heartbeat (tachycardia)
• A slow heartbeat (bradycardia)
• Chest pain
• Shortness of breath

Other symptoms may include:
• Anxiety
• Fatigue
• Lightheadedness or dizziness
• Sweating
• Fainting (syncope) or near fainting

Causes

Certain conditions can lead to, or cause, an arrhythmia, including:

• A heart attack that's occurring right now
• Scarring of heart tissue from a prior heart attack
• Changes to your heart's structure, such as from cardiomyopathy Blocked arteries in your heart (coronary artery disease)
• High blood pressure
• Overactive thyroid gland (hyperthyroidism)
• Underactive thyroid gland (hypothyroidism)
• Diabetes
• Sleep apnea

Other things that can cause an arrhythmia include:

• Smoking
• Drinking too much alcohol or caffeine
• Drug abuse
• Stress or anxiety
• Certain medications and supplements, including over-the-counter cold and allergy drugs and nutritional supplements
• Genetics

FAQ

What is Atrial Fibrillation (AF)?
AF is the irregularity and rapidity of heart beat. Patient is said to have atrial fibrillation when heart rate is in the range 100-200 beats per minute (normal is 80-100 beats per minute).

What causes AF? Who are prone to developing AF?
AF is caused by a disturbance in organisation of the heart structure or the rhythm generating centre of the heart. Most conditions that predispose to or result in AF are high blood pressure, hyperthyroidism, alcohol consumption, heart valve disorder, obesity, previous episodes of heart attacks, Diabetes etc.

What are the symptoms of AF?
Most common symptoms include shortness of breath, heart palpitations, chest pain, dizziness and weakness. In some cases, it may not produce any symptoms and may be detected only during a check-up.

What are the risks of long standing or untreated AF?
AF directly results in dysfunctional blood flow which can result in blood clot formation, lack of oxygen in body or even predispose to heart attack, stroke.

What is the procedure of AF surgery?
AF ablation surgery uses a catheter to reach the heart chambers via neck or groin veins. An electrode t the tip of the catheter uses radio waves/microwaves/ sonar to scar a part of the heart tissue which will no longer transmit irregular rhythm to the rest of the heart, thereby allowing regularity of rhythm in most parts of the heart.

Who should get an AF surgery?
In cases where AF is severe in nature, medical intervention has failed or compliance to medicines is less, an AF ablation surgery is recommended to correct the rhythm of the heart. If Digoxin (most commonly prescribed drug for AF) is contra-indicated in a patient due to age or other limiting conditions, surgery is recommended.

What are the complications associated with AF surgery?
Catheter ablation is a minimally invasive procedure and is very safe procedure. It rarely leads to complications like bleeding, blood clot formation.

How long does an AF surgery last?
The surgery typically takes between one to two hours for completion, depending upon the extent of area over which ablation is required.

What are the lifestyle modifications to be followed after an AF surgery?
Even before surgery, patient is advised to quit smoking and alcohol consumption is also limited. A healthy diet with inclusion of good cholesterol, fibre and exclusion of bad cholesterol is recommended. Medications to control or lower heart rate may be administered as well.

What is the success rate of AF surgery?
Using radio frequency ablation, success rate of the surgery is reported to be around 90%.

When can I return to work after an AF surgery?
Is there an alternative for AF surgery? The alternative for AF ablation surgery is MAZE – in which cuts are made to scar tissue instead of radio waves ablation. It is more successful than catheter ablation but is an open heart surgery (highly invasive).

Which is a better surgery for AF – ablation or MAZE?
MAZE is more successful; however, it is also more invasive procedure. It is done for patients who are undergoing open heart surgery for a coexisting condition. Hence, catheter ablation is preferred otherwise due to minimal invasion. Recently, MINIMAZE techniques are coming up which have advantages of both.