Surgical Procedures for Arrhythmias (Heart Rhythm Disturbances)

Surgery can be used to:

  • Take out tissue to break signals that cause abnormal heart rhythms
  • Place devices that restart and keep your heart rhythm normal

Tissue Removal

Radiofrequency Catheter Ablation

During radiofrequency catheter ablation, electrical currents that cause heart rhythm problems can be found and destroyed. A tube is placed in a vein and threaded to the heart. The heat destroys the harmful tissue. This is mainly used for atrial flutter, atrial fibrillation (AF) , or ventricular tachycardia (VT).

Maze Procedures

The maze procedure is a technique used to treat AF. It involves making many small cuts within the wall of the upper chambers. Scar tissue forms, blocking the signals that cause heart rhythm problems.

Mini-maze needs only 1 or 2 small cuts in the chest.

Subendocardial Resection

In some cases of VT, certain problems within the heart muscle might be the cause. Taking out the scar tissue under the lining of the heart may keep an arrhythmia from starting.

Implanted Devices

Pacemaker

If the sinoatrial node doesn't work as it should or it stops, a pacemaker can be placed. It will restart normal signals. A wire is attached to your heart either through a blood vessel or into the chest. The wire is also attached to the pacemaker. A cut is made in the skin. It’s placed under your skin. In most cases, it will be near the collarbone.

Pacemaker

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Cardioverter Defibrillator

An implantable cardioverter defibrillator (ICD) helps change harmful arrhythmias to healthy ones. It can also restart a heart that has had a sudden cardiac arrest. The implant sits just under the skin in the chest. Wires are passed through a blood vessel to the heart. An ICD is used for people with serious ventricular heart arrhythmias. These can lead to cardiac arrest and death. The ICD sends signals to:

  • Reset normal rhythms for some types of arrhythmias
  • Restart the heart to a normal rate
  • Restart a heart that has stopped beating

Implantable Cardioverter Defibrillator

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Pacemakers and ICDs have power sources that last a long time. But, they will need to be checked on a regular basis. Your healthcare team will help you learn how to care for your device.

References:

Arrhythmia. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/arrhythmia. Accessed January 4, 2019.
Colucci R, Silver M, Shubrook J. Common types of supraventricular tachycardia: Diagnosis and management. Am Fam Physician. 2010;82(8):942-952.
Horowitz LN, Harken AH, Kastor JA, Josephson ME. Ventricular resection guided by epicardial and endocardial mapping for treatment of recurrent ventricular tachycardia. N Engl J Med. 1980;302(11):589-593.
Implantable cardioverter defibrillator (ICD). EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated October 22, 2018. Accessed January 4, 2019.
Pacemakers. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T906162/Pacemakers. Updated October 16, 2018. Accessed January 4, 2019.
Last reviewed December 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC
Last Updated: 1/4/2019

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