What is Ablation Surgery?

More than two million Americans suffer from atrial fibrillation, a condition in which the upper chambers of the heart (the atria) begin to quiver instead of beating rhythmically. This can cause blood to remain in the atria, where it may form clots. If these clots go to the brain, a stroke results. Therefore, it is important to correct atrial fibrillation. The most common methods to rectify this include drugs to slow the heart, electrical shocks to restore normal rhythm, atrial pacemakers to maintain normal rhythm, and ablation surgery to destroy tissues that stimulate abnormal rhythm. Ablation surgery has become one of the most effective methods in treating atrial fibrillation, especially in patients who do not respond to drug treatment.

Ablation surgery is a procedure to destroy abnormal tissues. It is often used in patients who have "extra" tissue in their hearts that creates abnormal electrical impulses. These impulses interfere with the heart's normal electrical stimulating tissue, and this results in atrial fibrillation, or the quivering of the upper chambers of the heart. This surgery can take several forms, including standard surgery to sever the abnormal tissue, or procedures to freeze or burn the abnormal tissues.

The maze procedure is an open-heart surgical procedure. The heart is temporarily stopped and the surgeon makes tiny cuts in the heart at points where abnormal electrical impulses are fired toward the atrioventricular (AV) node. Scar tissue forms where the cuts are made, and this scar tissue blocks the electrical impulses.

This type of surgical ablation requires neither opening of the chest nor stopping of the heart. The surgeon inserts small endoscopes containing lights and cameras through small incisions in the chest and then makes tiny incisions in the heart to block the abnormal electrical impulses that stimulate the AV node.

The modified maze procedure is a popular and safer method to rectify atrial fibrillation. The surgeon inserts a catheter into the heart through which he delivers radiofrequency waves, microwaves, laser impulses or cryothermy (freezing methods) to destroy the electrical pathways between the abnormal tissue and the heart. This method is usually done on an out-patient basis.

Ablation surgery is beneficial in treating not only atrial fibrillation, but also ventricular tachycardia, AV nodal re-entry tachycardia (AVNRT) and accessory pathways. Ablation surgery benefits patients with heart arrhythmias and also can help control heart rates and reduce risks of blood clots and strokes.