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Minimally Invasive Atrial Fibrillation Surgery

What is Minimally Invasive Atrial Fibrillation Surgery?

Minimally invasive atrial fibrillation (AF) surgery is a procedure that treats irregular heart rhythms by precisely targeting and disrupting the abnormal electrical signals that cause AF. Unlike traditional open-heart surgery, this approach uses small incisions and specialised instruments to access the heart, resulting in less pain, faster recovery, and minimal scarring. One such technique is the Totally thoracoscopic maxe procedure, which uses radiofrequency energy to restore normal heart rhythm—often with long-lasting success.

Understanding Atrial Fibrillation (AF)

Atrial fibrillation (AF) is a common heart rhythm disorder characterised by a rapid and irregular heartbeat. It occurs when the upper chambers of the heart (the atria) beat out of sync with the lower chambers (the ventricles). This inefficient pumping can lead to symptoms such as: 

  • Heart palpitations 
  • Fatigue
  • Shortness of breath 
  • Dizziness or weakness

AF is not just uncomfortable—it can also be dangerous. It increases your risk of stroke by five to seven times and may lead to heart failure or reduced quality of life if left untreated.

There are several types of AF:

  • Paroxysmal AF – occurs occasionally and stops on its own 
  • Persistent AF – requires medical intervention (like cardioversion) to restore normal rhythm 
  • Permanent AF – remains ongoing despite attempts to correct it The type of AF you have will help guide your treatment options.

Why Does Atrial Fibrillation Happen?

AF is usually triggered by abnormal electrical impulses, most commonly originating in the pulmonary veins—the blood vessels that bring oxygenated blood from the lungs to the heart. These irregular signals prevent the heart from beating in a coordinated way.

Ablation—either by catheter or surgery—is the only treatment proven to cure AF by isolating or destroying the abnormal electrical pathways responsible for the arrhythmia.

The TT Maze Minimally Invasive Surgical Ablation Procedure

How It Works

The Bipolar Radiofrequency Ablation Catheter delivers radiofrequency (RF) energy to create precise lesions around the pulmonary veins in the left atrium. These lesions form a barrier that blocks abnormal electrical signals from spreading into the rest of the heart. Once the signals are interrupted, the heart can return to a normal rhythm—known as sinus rhythm.

This method has been shown to successfully restore normal rhythm in up to 90% of patients.

What to Expect During the Procedure

The procedure is performed under general anaesthesia. Your surgeon will:

  1. Make three small incisions between your ribs.
  2. Insert specialised surgical ports through these incisions to access your heart.
  3. Use a high-definition endoscopic camera to visualise the heart in real time.
  4. Insert the Bipolar Ablation Catheter, which is carefully placed on the outside of the heart around the pulmonary veins.
  5. Use suction to hold the catheter in place while radiofrequency energy is delivered to create the ablation lines.
  6. Conduct a test to ensure the abnormal signals are blocked and the procedure was effective.

Because it is minimally invasive, this approach typically results in less postoperative pain, a shorter hospital stays, and quicker return to normal activities.

Benefits and Risks

Benefits:

  • Restoration of normal heart rhythm (sinus rhythm)
  • Reduced symptoms such as fatigue, breathlessness, and palpitations
  • Lower risk of stroke and heart failure
  • Less invasive than open-heart surgery
  • Shorter recovery time and smaller incisions

Risks:

As with all surgical procedures, there are potential risks, which may include:

  • Bleeding or infection
  • Reaction to anaesthesia
  • Injury to surrounding heart structures
  • Rarely, stroke or other complications

It’s important to discuss all potential risks and benefits with your cardiothoracic surgeon to determine whether this procedure is right for you.

Is Minimally Invasive AF Surgery Right for You?

If you have been diagnosed with atrial fibrillation and are not responding to medication or catheter-based treatments, minimally invasive surgical ablation may be an effective next step. Speak with your specialist about whether the Fusion Minimally Invasive procedure is suitable for your specific type of AF and overall heart health.

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