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Cardiac Surgery

Surgery to Correct Atrial Fibrillation

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Atrial fibrillation is one of the most common arrhythmias or heartbeat disorders. The heart is a muscular pump divided into four chambers: two atria on top and two ventricles on the bottom. Normally, the atria contain the heart's natural pacemaker, which sends an electrical signal to the rest of the heart. As the signal travels through the heart, the heart contracts between 60 and 100 times per minute. During atrial fibrillation, the atria beat irregularly - often very rapidly - and out of rhythm with the rest of the heart, which interferes with the heart's overall pumping function.

In some cases, a minimally invasive procedure called radiofrequency ablation is performed to restore a normal heartbeat.

The Surgery

The surgeons at Montana Heart use the Maze or Modified Maze procedure to correct atrial fibrillation. Since most atrial fibrillation signals come from the four pulmonary veins, the physician isolates those veins electrically from the heart's left atrium, thereby blocking signals from those veins. This is accomplished using radiofrequency ablation.

Typically, the surgeon makes a small incision in a blood vessel in the groin in order to insert several catheters (long, thin tubes) that travel up to the heart. A device is inserted into one of the catheters, which enables the surgeon to see the inner structure of the heart on an external monitor. Tiny bits of radiofrequency energy are inserted through the catheters. The heat of this energy creates small lesions outside the pulmonary veins.

When the lesions heal, in about 4-8 weeks, scars form around the pulmonary veins. The scar blocks any impulses firing from within the pulmonary veins, thereby disconnecting the pathway of the abnormal rhythm and restoring a normal heartbeat.

For some patients, the ablation is an outpatient procedure. For others, recovery requires an overnight stay in the hospital.

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