Atrial fibrillation is the most common type of abnormal heart rhythm. With atrial fibrillation, electrical impulses don't follow a normal pathway through the heart. As a result, the heart doesn't beat normally or pump blood properly.

Having atrial fibrillation can lead to more than an abnormal heart beat. Patients experiencing atrial fibrillation are at risk for:

  • Blood clots
  • Stroke
  • Heart attack
  • Heart failure
  • Chronic fatigue
  • Death

Radiofrequency Ablation for Atrial Fibrillation

University of Chicago Medicine heart surgeons have been successfully treating atrial fibrillation for decades, and we offer the most advanced techniques to correct this condition. Surgical ablation (also referred to as a modified Maze procedure or Mini Maze procedure) involves the use of radiofrequency waves (modified electrical energy) to create precise scar lines on the heart's surface. These scars redirect the erratic electrical impulses of atrial fibrillation to a normal electrical pathway through the heart. Our surgeons use specially designed instruments to deliver the radiofrequency waves to the abnormal heart tissue.

Minimally Invasive & Robotic Surgical Ablation

[MUSIC PLAYING] I'm Linda Spiegel. I'm 57 years old, and back in 2004 I was diagnosed with atrial fibrillation. About the time I was diagnosed, I was a very avid runner doing marathons, half marathons, and really running on a daily basis. Well you know, I was hiking in Italy in 2004. Beautiful scenery, it was in the mountains with this hiking tour group, and my heart was racing unbelievably out of control. We thought it was the altitude. You kind of think of that cartoon where the cartoon characters heart goes boom, boom, boom.

Atrial fibrillation is actually a pretty serious condition, and it definitely increases one's risk of dying early, and what it is really is an abnormal electrical impulses which affect the upper chambers of the heart, causing them to beat rapidly and out of sync with the lower chambers of the heart. And as a result, this can lead to people feeling palpitations, anxiety, fatigue. It can also cause chest pain, and in the future it is also associated with the increased risk of developing heart failure, as well as seven times greater increased risk of stroke.

But when I learned about the University of Chicago Medical Center's introduction of the Da Vinci robot technique, and you know, and I did some research on it, and I actually e-mailed Dr. Jeevanandam and he called me and we spent some time chatting about it, and he really let me do due diligence and ask him a lot of questions.

Linda came to us from New York, and she came all the way to Chicago because we could offer something unique. And the unique thing we offered was to be able to do this not only minimally invasively, but potentially permanently.

He really cared, and you know, the other thing that sort of brought it home for me is he's also like myself, a very active person and very into fitness and health, but even more, when he shared with me that his own wife also has atrial fibrillation and this is what he wanted for her as well, I didn't have to think twice. I felt like when I flew here and got off the plane I'd never met any of these people before, but I felt as if I was coming to see friends.

So the new minimally invasive techniques that we've developed basically involves using one incision on each side of the chest, and basically using new technology we're able to create electrical scars within the heart, therefore decreasing the incidence of atrial fibrillation dramatically in these patients.

While I was in the hospital I had normal sinus rhythm for the first time in my life, and it never went away.

And so the major benefits are that we can get people back into normal sinus rhythm, have them be taken off of their antiarrhythmic medications, be off of their anticoagulation, which has significant risks for bleeding and other such complications, and along with this procedure we also remove the left atrial appendage, which is the major source of the formation of blood clots and the risk of stroke with atrial fibrillation.

It's a scary thought to be always wondering when is this bad thing going to happen? Well, when you have the conference that it's not going to happen, then you can achieve great things.

But the day of the New York Marathon while other people were running 26 miles in the midst of a crowd, I went on a four mile run by myself through the park near where I live, and it could have been a marathon. For me to run without my heart racing out of control, feeling good, and I just felt like myself again.

It's people like Linda and other patients like her that make work very rewarding.

Well I think we're always striving to push the envelope, and that is to continually improve patient safety and outcomes. And with that, applying the latest technology to advance the field and improve patient outcomes and safety.

I'm 100% cured, and you know, every day I really I thank God for my health, and I thank the surgeons at the University of Chicago Medical Center, because they gave me that level of confidence that this was the right thing to do, and the end of the story is it worked out perfectly. So I couldn't be happier.

[MUSIC PLAYING]

In many cases, surgical radiofrequency ablation can be performed using minimally invasive approaches, including robot-assisted techniques. Our world-renowned robotic heart surgeon performs surgical radiofrequency ablation on a beating heart without requiring the use of a heart-lung machine.

Surgical radiofrequency ablation can be performed in conjunction with other heart surgeries, such as mitral valve repair or coronary artery bypass for patients with co-existing heart conditions or can be a stand-alone procedure for patients with atrial fibrillation.

What to Know About Surgical Ablation

Surgical radiofrequency ablation for atrial fibrillation offers the following benefits:

  • 75 to 90 percent cure rate of atrial fibrillation
  • Reduction in risk of blood clots and stroke
  • Fewer or no symptoms related to abnormal heart rhythms
  • Reduction or discontinuation of blood thinners such as Coumadin
  • Reduction or discontinuation of antiarrhythmic drugs such as Amiodarone
  • Most patients who have had the procedure report an ability to exercise more frequently and for longer periods of time

In some cases, the procedure will reduce the size of the atria, therefore lessening the risk for other complications, such as heart failure.

Additional benefits of minimally invasive surgical ablation include:

  • No splitting of the breastbone (sternum)
  • Faster recovery than with a large chest incision
  • Less time spent in the hospital
  • Less pain, because the incisions are small
  • Minimal blood loss
  • Little scarring

Radiofrequency ablation for atrial fibrillation is an option if:

  • You have lone atrial fibrillation
  • Your atrial fibrillation is not well-controlled by medication
  • You have intermittent atrial fibrillation that is disabling
  • You require another type of heart surgery procedure, such as mitral valve surgery or coronary artery bypass surgery
  • You have a history of stroke or cannot take Coumadin

You may have heard about the Maze procedure, a surgical approach to treating atrial fibrillation that entails precise cutting of heart tissue to stop the abnormal heart rhythms. While this is an effective approach to treat atrial fibrillation, it does pose greater risks and complications than the radiofrequency approach.

In contrast to the Maze procedure, surgical radiofrequency ablation (modified Maze procedure) offers the following benefits:

  • It is usually performed without opening the chest through small, finger-sized ports
  • No need to use a heart-lung machine
  • No cutting or sewing of heart tissue
  • Significantly shorter operative time and recovery time in the hospital

Catheter ablation is similar to surgical ablation in the sense that both procedures are performed for the same purpose and they both use radiofrequency waves to treat abnormal heart rhythms. Catheter ablation involves the use of a catheter that is threaded through the leg and into the heart. The catheter is equipped with a device that delivers radiofrequency waves to the source of the arrhythmia. An electrophysiologist performs this procedure in a catheterization lab.

The surgical procedure is performed through small holes in the chest, usually with robotic assistance, and has the added benefit of ligating the left atrial appendage (the source of clots and embolic stroke in patients with atrial fibrillation).

Occasionally, for patients with long-standing atrial fibrillation, the two procedures are combined (hybrid ablation). Our expert electrophysicologists team up with our highly experienced robotic heart surgeon to get the maximum benefit from the two approaches in treating the rhythm problem.