by Polsdorfer R

Surgical Procedures for Arrhythmias (Heart Rhythm Disturbances)

Surgery can be used to:
  • Remove tissue to disrupt factors that cause arrhythmias
  • Implant devices that trigger and maintain regular rhythm

Tissue Removal

Radiofrequency Catheter Ablation
During radiofrequency catheter ablation , abnormal electrical circuits in the heart that generate harmful rhythms can be located and destroyed. A catheter is introduced through a vein and advanced until it reaches your heart. Then, electrodes are heated with a radiofrequency energy that subsequently destroys areas of the heart tissue that cause the arrhythmia. This procedure is most frequently used to treat atrial flutter , atrial fibrillation , or ventricular tachycardia .
Maze and Mini-Maze Procedures
The Maze procedure is a technique used to surgically treat atrial fibrillation (AF) that involves making several small incisions within the wall of the atria. This results in the formation of scar tissue that blocks the electrical impulses that cause the arrhythmia.
The Maze procedure may also be done as minimally invasive surgery, called mini-Maze . It only requires one or two small incisions in the chest.
Subendocardial Resection
In certain cases of a ventricular tachycardia, specific abnormalities within the heart muscle might be responsible for generating the arrhythmia. The removal of the scar tissue underneath the lining of the heart may prevent the arrhythmia from occurring.

Implanted Device

Pacemaker
If the sinoatrial node malfunctions or stops working, an artificial pacemaker can be implanted to generate regular impulses. Pacemakers are implanted during a minor procedure. A wire is attached to your heart either through a blood vessel or directly into the chest. The wire is also attached to the device. An incision is made, and the device is placed under your skin, usually near the collarbone.
Pacemaker
IMAGE
Copyright © Nucleus Medical Media, Inc.
These devices have power sources that last a long time. Nevertheless, they should be checked occasionally to make sure they are still working. Your cardiologist will give you instructions on the care and maintenance of your pacemaker or defibrillator.

References

Colucci R, Silver M, et al. Common types of supraventricular tachycardia: Diagnosis and management. Am Fam Physician. 2010;82(8):942-952. Available at: http://www.aafp.org/afp/2010/1015/p942.html. Accessed March 20, 2014.

Horowitz LN, Harken AH, et al. Ventricular resection guided by epicardial and endocardial mapping for treatment of recurrent ventricular tachycardia. N Engl J Med. 1980;302:589.

How are arrhythmias treated? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/arr/treatment.html. Updated July 1, 2011. Accessed March 20, 2014.

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