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Surgical Procedures for Arrhythmias (Heart Rhythm Disturbances)
by Ricker Polsdorfer, MD
Surgery can be used to:
Radiofrequency Catheter Ablation
During radiofrequency catheter ablation, abnormal electrical circuits in the heart that generate harmful rhythms can be located and destroyed. A catheter is introduced through a vein and advanced until it reaches your heart. Then, electrodes are heated with a radiofrequency energy that subsequently destroys areas of the heart tissue that cause the arrhythmia. This procedure is most frequently used to treat atrial flutter, atrial fibrillation, or ventricular tachycardia.
Maze and Mini-Maze Procedures
The Maze procedure is a technique used to surgically treat atrial fibrillation (AF) that involves making several small incisions within the wall of the atria. This results in the formation of scar tissue that blocks the electrical impulses that cause the arrhythmia.
The Maze procedure may also be done as minimally invasive surgery, called mini-Maze. It only requires one or two small incisions in the chest.
In certain cases of a ventricular tachycardia, specific abnormalities within the heart muscle might be responsible for generating the arrhythmia. The removal of the scar tissue underneath the lining of the heart may prevent the arrhythmia from occurring.
If the sinoatrial node malfunctions or stops working, an artificial pacemaker can be implanted to generate regular impulses. Pacemakers are implanted during a minor procedure. A wire is attached to your heart either through a blood vessel or directly into the chest. The wire is also attached to the device. An incision is made, and the device is placed under your skin, usually near the collarbone.
An implantable cardioverter defibrillator (ICD) is a device that can help change dangerous arrhythmias to healthy ones. It can also stimulate a heart that has had a sudden cardiac arrest. The implant sits just under the skin in the chest and wires are passed through a blood vessel to the heart. An ICD is used for people with serious ventricular heart arrhythmias. These arrhythmias are very likely to lead to cardiac arrest and death. The ICD can send signals to:
Pacemakers and ICDs have power sources that last a long time. Nevertheless, they should be checked occasionally to make sure they are still working. Your cardiologist will give you instructions on the care and maintenance of your device.
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.
How are arrhythmias treated? National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health/health-topics/topics/arr/treatment. Updated July 1, 2011. Accessed March 20, 2014.
Pacemakers. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T906162/Pacemakers. Updated April 20, 2017. Accessed June 1, 2017.
Last reviewed June 2017 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC
Last Updated: 12/20/2014
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