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An A-MAZE-ing New Treatment For Atrial Fibrillation
OSF Saint Anthony Medical Center Regional Heart Institute is using a leading edge surgery, known as the MAZE procedure, battle atrial fibrillation (AF), a common heart condition, particularly in older adults. With AF, the upper two chambers of the heart, called the atria, experience a fast and irregular beat and blood is not pumped effectively into the ventricle of the heart.

Although typically not life threatening, the condition can lead to complications such as stroke and congestive heart failure.

"Using the MAZE procedure, we essentially reroute the pathways of electricity through the heart, allowing the patient to resume a normal heart rhythm,” explained James P. Locher Jr., MD, FACS, a member of Rockford Surgical Service and independent physician with the Regional Heart Institute. “Using a small probe, we create a maze of incisions in the atria that blocks the flow of excess electrical impulses within the heart’s chambers.”

The surgical Maze operation is done in patients who need to undergo open-heart surgery for reasons other than AF and infrequently in other patients who are very troubled by AF and medications are not effective. It involves the surgeon making incisions in different regions of both atria to prevent the random transmission of electrical signals through the atria.

"It is very effective for patients who are having bypass surgery, valve surgery, or possibly both and experiencing atrial fibrillation,” Locher noted. “When these patients have a MAZE procedure along with heart surgery, about 80 percent of the time their hearts are back in a normal rhythm within six months. MAZE can improve their lifespan and quality of life.”

Typically, patients who undergo open-heart surgery combined with a MAZE procedure are in the hospital between four and six after before going home to undergo a period of recovery at home that usually lasts six to eight weeks.

A recent study published in the European Heart Journal found that after one year, normal heart beat rhythm was restored more often in the group that had MAZE surgery (80% of patients) compared to the group that had mitral valve surgery only (26.7%).

For more information on the MAZE procedure, talk with your doctor or call the Regional Heart Institute at 815.395.5493.

What Is Atrial Fibrillation?
Atrial fibrillation (AF) is a disorder found in about 2.2 million Americans. In it the heart's two small upper chambers (the atria) quiver instead of beating effectively. Blood isn't pumped completely out of them, so it may pool and clot. If a piece of a blood clot in the atria leaves the heart and becomes lodged in an artery in the brain, a stroke results. About 15 percent of strokes occur in people with atrial fibrillation.

The likelihood of developing atrial fibrillation increases with age. Three to five percent of people over 65 have atrial fibrillation.

How is atrial fibrillation treated?
Several approaches are used to treat and prevent abnormal beating:

• Medications are used to slow down rapid heart rate associated with AF. These treatments may include drugs such as digoxin, beta blockers (atenolol, metoprolol, propranolol), amiodarone, disopyramide, calcium antagonists (verapamil, diltiazam), sotalol, flecainide, procainamide, quinidine, propafenone, etc.
• Electrical cardioversion may be used to restore normal heart rhythm with an electric shock, when medication doesn't improve symptoms.
• Drugs can sometimes restore the heart's normal rhythm. These drugs are given under medical supervision, and are delivered through an IV tube into a vein, usually in the patient's arm.
• Radiofrequency ablation may be effective in some patients when medications don't work. In this procedure, thin and flexible tubes are introduced through a blood vessel and directed to the heart muscle. Then a burst of radiofrequency energy is delivered to destroy tissue that triggers abnormal electrical signals or to block abnormal electrical pathways.
• Surgery can be used to disrupt electrical pathways that generate AF.
• Atrial pacemakers can be implanted under the skin to regulate the heart rhythm.

Treating atrial fibrillation is an important way to help prevent stroke. That's why the American Heart Association recommends aggressive treatment of this heart arrhythmia.

Source: The American Heart Association