The Convergent Procedure for Atrial Fibrillation
At the Maimonides Heart & Vascular Center, we have adopted a multidisciplinary approach to the treatment of atrial fibrillation, drawing on the expertise of cardiothoracic surgeons and electrophysiologists (EPs). This convergent procedure is a minimally invasive, epicardial (outside the heart) and endocardial (inside the heart) approach to treatment.
The convergent procedure offers access to the heart without requiring chest incisions or ports, lung deflation, or pericardial dissections. First, the surgeon inserts a videoscope to view the beating heart through a single, small incision in the abdomen. The surgeon then creates a series of linear lesions on the surface of the heart using radiofrequency ablation. Finally, the electrophysiologist uses three-dimensional endocardial mapping and ablation inside the heart to isolate the pulmonary veins and the posterior left atrium.
The Maze Procedure
A surgical procedure called the Maze Procedure has had excellent results in curing AF. This procedure requires that the cardiac surgeon open the chest, use a heart-lung machine and make numerous small incisions on the atria to block the flow of excess electrical signals that cause AF. Although this is an extremely successful procedure, it is limited in its acceptance due to the invasive technique used.
Recent advances, pioneered by the doctors at Maimonides, have greatly simplified surgery to stop AF. They have developed a technique known as Endoscopic Microwave Ablation (or a modified Maze), which is much faster and safer than the Maze. In this procedure, surgeons use radio frequency or microwave energy probes to create the same scars as traditional surgery, but does not require the use of a heart-lung machine. It does not require stopping the heart or making incisions on it. It can be performed through tiny key-hole incisions in the chest and usually can be completed within two hours. Patients often go home the day after surgery.
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