Irregular heartbeats, or arrhythmia, can significantly affect a person’s quality of life and overall health. When medication and lifestyle changes are ineffective, doctors may recommend surgery to treat arrhythmia.
An arrhythmia, or irregular heartbeat, can mean the heart might beat too fast, too slow, or unevenly. Different surgical approaches can treat arrhythmia, including cardiac ablation or undergoing implantation of a medical device. Cardiac ablation is a minimally invasive procedure that doctors often use to target and destroy the heart tissue causing the atypical rhythm.
This article delves into the various aspects of surgery for arrhythmia, specifically focusing on cardiac ablation, providing a comprehensive overview of what people can expect.
Arrhythmias affect approximately
Depending on what part of the heart is affected and whether arrhythmia leads to a slow, fast, or irregular heart rate, several surgical treatment options are available. These include the following.
Catheter ablation
This is a type of cardiac ablation.
Catheter ablation involves threading thin, flexible tubes called catheters through blood vessels to the heart. The catheters record the heart’s electrical activity and help pinpoint the source of the arrhythmia.
Once surgeons locate the areas of heart tissue causing the irregular heartbeat, they destroy it by administering radiofrequency to generate heat or by using freezing.
Surgical ablation
Surgical ablation — also known as maze surgery — is an open-heart surgery that doctors use to treat atrial fibrillation (A-fib), a type of arrhythmia.
It involves making small incisions in the atria to create a “maze” of scar tissue. This scar tissue disrupts the transmission of atypical electrical pathways, helping restore a natural heartbeat.
Some individuals undergo a minimally invasive procedure, known as a mini-maze, where surgeons make smaller incisions to reduce the risk of complications. Recovery is generally much shorter and easier, and most people are A-fib-free afterward.
Hybrid surgical-catheter ablation
Hybrid surgical-catheter ablation combines both surgical ablation and catheter ablation. Catheter ablation targets the inside of the heart, and the mini-maze procedure targets the outer layer of the heart.
Implantable cardioverter defibrillator (ICD) insertion
Doctors perform surgery for arrhythmia when other treatments, such as medications or lifestyle changes, cannot manage symptoms effectively.
The primary goals of surgery for arrhythmia are to:
- restore a regular heart rhythm
- prevent blood clots and reduce the risk of stroke
- improve overall heart function and quality of life
- improve symptoms such as palpitations, dizziness, or fainting
While cardiac ablation and other surgeries for arrhythmia are generally safe, they carry certain risks. Potential complications include:
- bleeding or infection at the catheter insertion site
- damage to blood vessels or the heart
- arrhythmias that persist or recur
- blood clots, which can lead to stroke or heart attack
- damage to the artery at the catheter insertion site
Discussing these risks with a healthcare professional can help people make an informed decision about whether to undergo surgery.
Preparing for arrhythmia surgery usually involves:
- Consultation: A person meets with a cardiologist or heart specialist to discuss the procedure, potential risks, and benefits.
- Preoperative testing: Individuals undergo tests to assess heart function, such as:
- Medication management: A person adjusts or stops certain medications, such as blood thinners, under medical supervision.
- Fasting: Individuals refrain from eating or drinking for several hours before the procedure.
It is important to understand what to expect when undergoing surgery for arrhythmia, such as cardiac ablation.
Before
Patients typically arrive at the hospital a few hours before the procedure.
Medical staff will:
- conduct a preoperative assessment
- insert an intravenous (IV) line and administer medication to help the person relax
During
During catheter ablation, people remain awake but sedated. This means they should not feel any pain.
A doctor inserts catheters through a vein, usually in the groin, and guides them to the heart. Using imaging technology, they identify and ablate the problematic tissue.
The procedure can take as little as 15 minutes. More complex procedures can take 3 to 4 hours, including preparation before and a recovery period afterward.
After
Doctors will monitor patients in a recovery area for 15 to 30 minutes.
A person may need to lie down for a few hours to prevent bleeding from the catheter insertion site. They can usually go home on the same day, though some may need an overnight stay.
Recovery from cardiac ablation typically involves a few days of rest, and people should avoid strenuous activity for at least 2 weeks. It is vital to follow their doctor’s instructions regarding medication and follow-up appointments.
Individuals need to contact a doctor immediately if any of these symptoms occur:
- persistent pain or swelling at the catheter site
- fever or chills
- shortness of breath
- chest pain
- excessive bleeding or bruising
Some individuals undergoing cardiac ablation may experience a recurrence of arrhythmia. In these cases, depending on the person’s specific circumstances and overall health, a doctor might recommend repeating the procedure.
The outlook for people who have cardiac ablation surgery is generally positive. The long-term success rate for treating AFib through cardiac ablation ranges from
Despite the possibility of recurrences and complications, cardiac ablation is an effective treatment for heart arrhythmias.
Life expectancy after cardiac ablation surgery
For many people, cardiac ablation can significantly improve quality of life and reduce the frequency and severity of arrhythmias. For some, treating certain heart arrhythmias may potentially extend their life.
The success rate can exceed
How serious is heart ablation surgery?
Doctors consider heart ablation surgery safe and minimally invasive, but like any medical procedure, it carries a degree of risk.
The risk of serious complications occurring with cardiac ablation for arrhythmia is rare, making it a popular treatment choice.
Is there surgery for arrhythmia?
Yes, surgery can treat arrhythmias. This might include procedures like catheter ablation, surgical ablation, or surgery to fit an ICD.
What is the best treatment for arrhythmia?
The best treatment for arrhythmia depends on the type and severity of a person’s condition.
While medications and lifestyle changes can help to treat arrhythmias, sometimes a surgical procedure is the best option.
How long does it take to recover from ablation surgery?
Recovery from catheter ablation can take a few days to a week. Most people can resume their usual activities within a few days, though doctors recommend avoiding heavy lifting for at least 2 weeks.
When medication and lifestyle changes have not been effective in treating arrhythmia, doctors may recommend surgery such as cardiac ablation. This is a minimally invasive procedure that targets and destroys heart tissue causing the atypical rhythm.
With proper care and follow-up, many individuals who undergo cardiac ablation can achieve a significant improvement in their heart rhythm and overall quality of life.