Minimally Invasive Surgery Works for Atrial Fibrillation

A minimally invasive surgical procedure to treat atrial fibrillation—a common heart rhythm abnormality—appears to work as well as the traditional surgical treatment and takes half the time, according to researchers at Washington University School of Medicine in St. Louis.

"This is very good news because it means more surgeons can perform the procedure and it will be applicable to virtually all patients with this irregular rhythm," says principal investigator, Dr. Ralph J. Damiano, chief of surgery. "Our findings show that this technique is much easier to perform but works just as well as the more invasive approach."

The New Procedure

In the traditional surgical technique, called the Cox maze procedure, surgeons make small incisions in the atria—the heart's two upper chambers. These incisions create scar tissue that act as barriers to the abnormal electrical signals that cause atrial fibrillation.

This surgery is technically difficult and not all patients are healthy enough to endure it. The heart must be temporarily stopped during the surgery and blood circulation must be done by a heart-lung machine during that time.

Damiano and his team developed an alternative form of the Cox maze procedure that uses two electrodes. These electrodes pass an electrical current through a targeted area of the heart, heating and killing a thin band of tissue. This creates the scar tissue that is necessary to block abnormal electrical signals.

This new method was tested on 40 patients and the success rate was similar to that of the traditional surgery. The less invasive procedure took an average of 54 minutes, compared with an average of 93 minutes for the traditional procedure.

"Shorter operative times are important for patient safety and outcome. If we shorten the procedure, it decreases the time we need to keep patients on the heart-lung machine. We are working in the laboratory on an approach that someday will allow us to perform atrial fibrillation surgery on the beating heart," Damiano says.

What Are Heart Murmurs?

A heart murmur is an extra or unusual sound that is heard when listening to the heart through a stethoscope.

Murmurs can be faint or relatively loud and sometimes sound like a "whooshing" or "swishing" noise. A murmur could be nothing to worry about or, in rare cases, could signal a serious heart problem.

A person who has a so-called "innocent" murmur has a normal heart and usually has no other symptoms of a heart problem, according to the National Heart, Lung, and Blood Institute. Innocent murmurs are common in healthy children.

A child who has an abnormal murmur usually has other signs of a heart problem, which often has been present since birth. In adults, abnormal murmurs are most often due to heart valve problems that are caused by infection, disease or aging.

If you suspect you or your child has a heart murmur, have a doctor evaluate the condition as soon as possible.