Surgical Atrial Fibrillation (AFib) Treatments 

Surgical Treatment Options

For some patients, surgical options may be considered. You’ll hear the term “ablation” used regularly in our AFib center; it means using either heat or cold to destroy abnormal tissues in the heart that are causing your heart to flutter. Ablation blocks abnormal electrical signals in your heart.

Surgical ablation procedures offer an excellent chance of curing atrial fibrillation. The success rate of each approach varies, and the type of AFib a patient has can play a role in options that are available. As with any surgical procedure, some level of risk is involved, and your doctor will discuss that risk with you. We perform over 100 surgical ablations every year for atrial fibrillation.

Open-Chest Surgical Ablation

Many patients are treated with an open-chest operation called a Maze procedure, which is highly effective for a wide range of atrial fibrillation patients. It can be a cure, but is highly invasive, requiring open-heart surgery and heart lung bypass.

The surgeon uses instruments to identify the faulty electrical sites in the heart that are causing it to beat irregularly and too fast. Then, an instrument with a source to heat or freeze tissue is used to create precise ablation lesions. This can return the heart to a normal rhythm.

Some patients with AFib who need open-heart surgery for another reason, such as bypass surgery or valve replacement or repair, may have their surgeons perform this procedure too. It takes only another 15 to 25 minutes to create the necessary scars that can block the abnormal electrical impulses. Many surgeons will also remove or close off a small out-pouching of the heart (the left atrial appendage) that is believed to be the main site where stroke-causing clots form during atrial fibrillation.

Minimally Invasive Surgical Ablation

Doctors have developed a minimally invasive approach often called the "mini-Maze." It is similar to open-chest ablation, except the surgeon gains access to the heart through three tiny incisions on each side of the chest. Through these incisions, endoscopic cameras and instruments are passed into the chest. The approach usually takes about four hours, and because the chest does not have to be opened and no heart-lung machine is required, recovery is much easier and the average hospital stay is around two to three days.

Hybrid Ablation

Our team has had one of the longest and most advanced experience with hybrid ablation. We pioneered this approach over 6 years ago and now many patients who have had prior failed catheter ablation or been in atrial fibrillation for several years can have a shot at having their atrial fibrillation converted to sinus rhythm with this approach. Using this approach, patients may have a combination of both surgical and catheter ablation using a staged approach. Hybrid ablation is especially useful for patients who have failed prior therapies.