May 1, 2005 Researchers have developed a method to quiet atrial fibrillations without having to perform open-heart surgery. In a technique called Mini-Maze, doctors insert a bi-polar-radio-frequency clamp on the heart by creating tiny incisions in the ribs. Energy flows through the clamp forming scar tissue that blocks the erratic electrical pulses.
Atrial fibrillation is a disorder that causes the heart's two small upper chambers to quiver at 300- to 600-times-a-minute. This rapid heartbeat leaves patients short of breath, dizzy, fatigued and of course, frightened. Now, a breakthrough steadies the heart and gives patients some much-needed relief.
Two-point-five-million Americans have atrial fibrillation, a condition that leaves them with an erratic, racing heart.
"It gives the patients the feeling of impending doom. They think, 'Is this what a heart attack feels like?' when they first have it," says Dr. Randall Wolf, a cardiothoracic surgeon at University of Cincinnati.
It's not a heart attack, but it can lead to a stroke. Many patients steer clear from invasive open heart surgery to fix it. Now, Dr. Wolf has developed an easier way to quiet the problem.
Through small incisions between the ribs, doctors insert a bi-polar-radio-frequency clamp on the heart. Energy flows through the clamp forming scar tissue that blocks the erratic electrical pulses in a heartbeat.
Dr. Wolf says, "We're at the point here, based on the patients we've reviewed here at the University of Cincinnati, that we are curing atrial fibrillation with a minimally invasive approach."
He is now training doctors across the country to do the new Mini-Maze procedure. Dr. Cliff Van Meter says the procedure is a breakthrough.
"It's much like a maze that has no way out. The heart can now beat regularly because this abnormal focus of electrical activity is isolated," says Dr. Van Meter, a cardiac and thoracic surgeon at Ochsner Clinic in New Orleans. He also says it's changed the way he talks to his patients. "Now we can say to them, 'We can assure you that we've reduced your risk of having a stroke.'"
That was all George Rabe needed to hear from his doctor. "As far as I'm concerned, he saved my life ... not living wise, but being part of life." His Mini-Maze procedure went off without a hitch, and he'll soon be skydiving again.
Research so far shows the procedure fixes the heart in more than 80 percent of patients. Surgeons across the country are currently being trained to do this procedure.
The original maze procedure required many incisions, sewing the upper chambers of the heart (right and left atrial), and a long operation.
The heart pumps by generating electrical impulses to contract the heart muscles in a precisely coordinated manner, and keep the heartbeat regular.
Normally, the heartbeat starts in the right atrium, when a special group of cells (the "pacemaker" of the heart) sends an electrical signal causing the muscles to contract. These signals travel through connecting fibers to all parts of the ventricles, and must follow the exact route in order for the heart to pump properly.
An arrhythmia occurs when the heart beats too fast, too slow, or irregularly. This keeps the heart from pumping blood properly.
Every cell in the heart muscle tissue is capable of starting electrical impulses. That's why we all experience an occasional premature, rapid or irregular heartbeat. These are called palpitations, and are usually a benign condition. But irregularities that happen often indicate arrhythmia, which occurs when another part of the heart takes over as "pacemaker," disrupting the usual route.
There are many types of arrhythmia, identified by where they occur in the heart (in the atria or ventricles), and by what happens to the heart's rhythm when they occur. One example is atrial fibrillation, an irregular heartbeat that interferes with the heart's ability to pump blood. Abnormal electrical signals cause the atria, or upper chambers of the heart, to contract erratically. Blood then pools in the atria and forms clots. These can travel to the brain and cause a stroke. The most serious arrhythmia is ventricular fibrillation, where the lower chambers quiver and the heart can't pump any blood. This results in collapse and sudden death -- if there isn't immediate medical attention.
Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.