Surgery for Atrial Fibrillation: Types, Risks, and More

Surgery for Atrial Fibrillation: Types, Risks, and More

What is atrial fibrillation?

Atrial fibrillation (A-fib) is a condition that involves an abnormal heartbeat, or arrhythmia. In normal sinus rhythm, the upper and lower chambers of your heart beat synchronously to pump blood. In A-fib, the electrical signals that coordinate the two chambers of your heart don’t work together as they should. This causes your heart to contract erratically. As a result, your heart beats too fast, two slow, or irregularly.

A-fib can happen on a single occasion. In this case, you probably won’t need treatment. But if you develop chronic A-fib, you will need treatment. If left untreated, it can lead to dangerous problems. According to the Cleveland Clinic, it can increase your risk of stroke by five to seven times. When you’re experiencing A-fib, blood can pool in your atria rather than pump out regularly. This can cause blood clots to form, which can lead to stroke. Your heart tissue may also become damaged, which can eventually lead to heart failure.

Symptoms of A-fib include:

  • chest pain
  • heart palpitations
  • fatigue
  • weakness
  • dizziness
  • confusion
  • shortness of breath

In some cases, it doesn’t produce any noticeable symptoms.

If you develop chronic A-fib, there are many ways you can treat it, starting with lifestyle changes. Your doctor will likely advise you to quit smoking and follow a heart-healthy diet. They may also prescribe medications to help your heart function more efficiently. In more severe cases, they may recommend surgery.

Learn about the different types of surgery used to treat A-fib.

Ablation surgeries

There are many types of ablation surgery available for A-fib. If your doctor recommends ablation, the specific type will depend on the area of your heart where the electrical misfiring begins. It will also depend on whether your A-fib occurs frequently or not.

Ablation procedures are minimally invasive surgeries. They are typically performed in hospitals over the course of about two hours. During the procedure, your surgeon will likely insert a catheter through a vein in your groin or neck. They will thread the catheter through your vein to the upper and lower chambers of your heart. The catheter will have an electrode at its tip, which will likely emit radio waves to create heat. Your surgeon will use this heat to destroy and scar an area of your heart tissue. Misfiring electrical signals won’t be able to cross the scar tissue.

Radiofrequency ablation is the most common type of ablation used. According to the American Heart Association (AHA), it can cure irregular heartbeats in over 90 percent of cases. But other types of energy, rather than radio waves, can also be used. Other types of ablation include sonar, microwave, and cryoablation. If you undergo cryoablation, your surgeon will freeze an area of your heart tissue to destroy and scar it.

Atrioventricular node ablation

In some cases, you may need a more extensive type of ablation, known as atrioventricular node ablation (AVN). This procedure is similar to the catheter ablation surgeries described above, but it destroys a larger area of your heart, known as your atrioventricular node. If you undergo AVN, you will need to have a permanent pacemaker installed in your heart to establish and maintain a normal heart rhythm after your surgery.

Risks of ablation

While any medical procedure carries risks, complications from ablation surgeries are rare.

Side effects include:

  • mild pain
  • bleeding
  • bruising
  • vein problems

More serious complications include stroke or abnormal fluid collection around your heart, but these complications are rare. Your healthcare team will closely monitor you after your procedure to watch for signs of problems.

Maze procedure

A-fib is common in patients who have other heart conditions. If you have a condition that requires open-heart surgery, such as coronary bypass surgery, your surgeon can use the Maze procedure to treat A-fib at the same time.

During the Maze procedure, your surgeon will make a number of incisions in your heart and sew them together. Just like catheter ablation, this will create scar tissue that your heart’s electrical signals can’t cross. This will reroute the signals so they function normally.

This surgery is called the Maze procedure because it creates a mazelike pattern for your heart’s electrical signals to follow.

Risks of the Maze procedure

The Maze procedure involves greater risks than ablation because it involves open-heart surgery. Risks include:

  • stroke
  • kidney failure
  • other organ failure
  • death

You may also require a pacemaker after undergoing the Maze procedure.

While it poses risks of serious complications, the Maze procedure also has a high success rate. To lower your risk of complications, choose an experienced surgeon to perform your procedure.

The takeaway

A-fib can be a potentially uncomfortable and dangerous health problem. Fortunately, there are many options available to treat it. If lifestyle changes and medications aren’t enough, your doctor may recommend surgery.

If you don’t need open-heart surgery to treat other heart conditions, your doctor will likely recommend ablation surgery. This minimally invasive procedure involves a low level of risk and high success rate. If you have more complicated heart problems that require open-heart surgery, your surgeon can use the Maze procedure to treat your A-fib. This procedure is more invasive and involves higher levels of risk.

Ask your doctor about your specific condition, treatment options, and outlook. They can help you understand the potential benefits and risks of undergoing surgery to treat A-fib.

Read This Next

What Are the Stroke Risks for Women with AFib?
Living with Atrial Fibrillation
How Can I Manage My AFib Symptoms?
AFib Categories: Understanding Your Diagnosis
Supporting a Loved One with AFib