Atrial fibrillation treatment can be effective with new guidelines for surgical ablation

By: Mohan Garikiparithi | Heart Health | Tuesday, January 10, 2017 - 06:00 AM

Atrial fibrillation treatment can be effective with new guidelines for surgical ablationAtrial fibrillation treatment can be effective with new guidelines for surgical ablation. Coauthor of the study Vinay Badhwar explained, “These guidelines represent nearly two years of effort by some of the nation’s leading experts in the surgical treatment of atrial fibrillation. This important document highlights the increasing global evidence on the safety and efficacy of surgical ablation for the treatment of Afib [atrial fibrillation].”

The literature review revealed a steady development of surgical ablation as a treatment for atrial fibrillation over the last 30 years with frequency and success increasing. Based on this, the guideline committee has put together up-to-date recommendations, concluding that surgical ablation is effective at reducing atrial fibrillation and improving quality of life. Therefore, surgical ablation should have a larger role in adult cardiac surgery.

It is well known that atrial fibrillation increases the risk of blood clots, strokes, heart failure, and other heart-related complications resulting from an irregular heart rhythm.

Dr. Badhwar added, “It is recognized that surgical ablation impacts long-term outcomes with improvements in normal heart rhythm, quality of life, and stroke reduction. Current evidence reveals that surgical ablation can be performed without significant impact to major complications or death.”

Surgical ablation is also known as the maze procedure. The surgeon makes very specific and defined lesions in the heart, allowing the scar tissue to form. This scar tissue blocks abnormal electrical signals and creates a controlled path for electricity flow in the heart. Over time, this helps normalize the heartbeat.

Surgical ablation can be done on its own or combined with other therapies. The experts developed new guidelines as a way of improving the safety of the procedure. The new recommendations are all evidence-based and offer insight on the following:

  • Surgical ablation for atrial fibrillation at the time of parallel mitral operations to restore cardiac rhythm
  • Surgical ablation for atrial fibrillation parallel to isolated aortic valve replacement, isolated coronary artery bypass graft, and both operations to restore cardiac rhythm
  • Surgical ablation as a primary standalone procedure to restore cardiac rhythm for symptomatic atrial fibrillation that is resistant to drugs or catheter ablation.

Dr. Badhwar concluded, “These guidelines may help guide surgeons when faced with a challenging decision on the management of Afib. The guidelines represent an assimilation of the world’s literature; they do not supersede the final medical decision of the surgeon. It is important to remember that the ultimate choice of any therapy remains between the patient and their doctor.”


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Sources:

http://www.annalsthoracicsurgery.org/article/S0003-4975(16)31615-0/abstract

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