Atrial Fibrillation Surgery
There are many different treatment options for atrial fibrillation:
- Chemical cardioversion - medicines to correct the irregular heart beat
- DC cardioversion - an electric shock delivered to jump start the heart (usually done with general anaesthetic)
- Rate control - medicines to leave the heart beat irregular but stop it from racing (often used in conjunction with anticoagulation)
- Anticoagulation - medicines to thin the blood to reduce the chances of blood clotting in the heart and therefore reduce the stroke risk
- Catheter ablation - keyhole techniques using needles in the groin to introduce wires to the heart via the blood vessels. These are used to burn away the abnormal electrical conduction systems
- Surgical ablation - cardiac surgery to burn scars into the heart to correct the heart rhythm
Most patients will arrive at the surgical clinics with atrial fibrillation that has either been associated with another heart condition (e.g. heart valve disease) or that is resistant to other forms of treatment. The cardiologists will normally try other treatment options first.
The type of surgery offered for atrial fibrillation depends on a number of factors:
- Underlying cause
- Duration of time in atrial fibrillation
- Swelling of the atria
- Previous treatments attempted
A number of different surgical options for atrial fibrillation exist which have varying degrees of invasiveness:
- Open surgery (through a median sternotomy) to burn all affected areas of the heart. This is the most invasive type of AF surgery but also with the highest success rates. It is usually offered in conjunction with other heart surgery e.g. valve surgery.
- Left atrial appendage occlusion (sometimes known as AtriClip or left atrial appendage ligation or amputation) where the blind ending sac in the left atrium most at risk of developing clots is blocked off to reduce stroke risk. This is often used in conjunction with other treatments as it is a quick and low risk addition to the operation.
- Keyhole surgery to burn the most common areas affected from the outside of the heart without using cardiopulmonary bypass.
- Keyhole surgery to burn all the key areas affected with irregular rhythm - this requires the heart to be stopped and opened with cardiopulmonary bypass
Most surgeons will be able to discuss with you the options for open atrial fibrillation surgery.
Surgeons offering minimally invasive AF surgery:
Mr Neeraj Mediratta
Cardiac & Thoracic ConsultantHeart Surgery Team
Mr Paul Modi
Cardiac ConsultantHeart Surgery Team