For Immediate Release
Contact: Susan Preston
10/26/05—RWJMS Surgeons Perform New Jersey’s First Atrial Fibrillation Procedure
-Innovation Offers Patients Better Recovery Without Open Heart Surgery-
Surgeons at the University of Medicine and Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School performed a new surgical procedure on a heart patient who would otherwise have faced major cardiac surgery or a life-time of medication.
The surgery, performed at Robert Wood Johnson University Hospital in late September, was the first invasive thoracscopic microwave ablation procedure performed in New Jersey. The patient, a 56-year-old Metuchen man, was released from the hospital on October 4.
"We are now able to disrupt the electrical impulses causing the irregular heart beat and promote normal rhythm without major surgery," said Dr. Peter M. Scholz, chief of the Division of Cardiothoracic Surgery at Robert Wood Johnson University Hospital and at UMDNJ-Robert Wood Johnson Medical School. "Over time, the patient should experience a return of the energy and stamina sapped by atrial fibrillation. For many patients, this is the first step towards a better quality of life."
This minimally invasive surgery is used to treat atrial fibrillation, an irregular heart beat that can leave the patient out of breath, weak and at increased risk of stroke. About 2.4 million Americans suffer from atrial fibrillation, making them five to seven times more likely to have a stroke.
Traditionally, the surgical treatment for atrial fibrillation, known as the Cox-Maze procedure, involved a major operation. Doctors cracked the breastbone and stopped the heart, putting the patient on a heart-lung machine. Recovery time was extensive.
As a result, the procedure was generally only performed on patients in conjunction with other planned cardiac surgery, such as valve repair and coronary artery revascularization.
Now, however, patients can realize the benefits of the Maze operation in a stand-alone procedure, without undergoing a major, open-heart operation.
In thoracoscopic microwave ablation, the surgeon gains access to the heart through a series of keyhole-sized incisions on the sides of the chest.
In atrial fibrillation, the electrical signals from the upper chambers of the heart (the atria) are fast and irregular, causing the atria to quiver instead of beating effectively. To fix it, surgeons seek to isolate the electrical signals causing the problem. This is typically done by creating a lesion or burn around the atrium through microwave energy. If successful, the resulting scar tissue will prevent the abnormal electrical impulses from affecting the rest of the heart.
Using a tiny video camera to guide small instruments, the surgeons loop a catheter, a thin plastic tube, around the heart. To allow better access to the heart, each lung is temporarily deflated in turn to allow the catheters to be threaded around the pulmonary veins.When the catheter is activated with microwave energy, it creates a lesion around the atrium that will scar and block the electrical impulses causing the irregular heart beat.
"The procedure takes a few hours using general anesthesia but does not require use of a heart lung machine as in traditional open heart surgery. The risk of complications with this procedure is much less than those associated with open heart surgery," said Dr. Scholz, who performed the operation with surgeons Manisha Shende, MD, and Juan Plate, MD, assistant professors of surgery at UMDNJ-Robert Wood Johnson Medical School.