At St. Joseph's Hospital, we use a vast array of procedures to treat Atrial Fibrilation (AFIB). Your physician will suggest the most effective treatment for your condition, but here is some general information about some of the procedures which may improve your specific symptoms:
Catheter-based Minimally Invasive Cryoballoon Ablation
The Arctic Front system is the first cryoablation balloon catheter available in the US after the FDA approved the technology for the treatment of drug-refractory paroxysmal atrial fibrillation in mid Dec 2010. In two hundred forty five patients at 26 centers, including St. Joseph's Hospital, cryoballoon ablation was compared with anti-arrhythmic drug therapy. In the trial, 69.9% of patients treated with Arctic Front were free from atrial fibrillation at one year, defined as no detectable AF during the period, no use of study drugs, and no AF interventions. Only 7.3% of the patients treated with drug therapy were AF free at one year. For more information, click here Arctic Front Cardiac CryoAblation.
Cryoballoon ablation is for the treatment of drug-refractory paroxysmal atrial fibrillation. During the procedure, the cryoballoon catheter is deployed in the left atrium. The physician inflates the balloon and moves it to the opening of the pulmonary vein. Contrast dye is then injected to assure that the opening of the pulmonary vein is closed off. The physician then introduces a liquid refrigerant into the balloon. Heat is then removed from the tissue by the refrigerant and, as a result, scars the tissue so that it may no longer spread electrical current that causes atrial fibrillation. For more information, click here Catheter-based Minimally Invasive Cryoballoon Ablation.
Catheter-Based Pulmonary Vein Isolation/Ablation
Pulmonary vein isolation (PVI), also called pulmonary vein ablation PVA, blocks the irregular impulses causing atrial fibrillation. During PVI, catheters are inserted into the blood vessels of the atrium. The catheters are directed to precise locations in the heart and “map” or search for the electrical impulses that fire abnormally. Energy is delivered through the catheters to the area of the atria that connects to the pulmonary veins, where the abnormal impulses originate. This energy produces a circular scar (ablation) that blocks any impulses firing from within the pulmonary vein. The pathway of the abnormal rhythm is “disconnected” and atrial fibrillation is corrected. For more information, click here Catheter-Based Pulmonary Vein Isolation.
Minimally Invasive Lariat Suture Delivery Device
The minimally invasive Lariat procedure reduces stroke risk in patients with atrial fibrillation who are unable to take blood thinning medications. The FDA approved Lariat Suture Delivery Device, manufactured by SentreHeart Inc., ties off the left atrial appendage (LAA). The LAA is a small pocket that is attached to the left atria of the heart where clots often form. The Lariat suture blocks stroke causing clots from traveling to the brain. The Lariat procedure is done under general anesthesia using two catheters. A catheter carrying the suture device is inserted under the patient’s rib cage, another catheter, which guides it into place, is sent to the LAA from an artery in the groin. Once in place, the Lariat Suture Delivery Device places and tightens a loop stitch around the base of the LAA permanently sealing it off from the rest of the heart. For more information, click here SentreHeart.
Minimally Invasive Surgical Ablation Approach
Patients with paroxysmal (intermittent) atrial fibrillation are candidates for minimally invasive surgical ablation. Approaches include keyhole surgery or a completely endoscopic approach. In both techniques, the procedure includes isolation of the pulmonary veins and excision (removal) of the left atrial appendage, a potential source of blood clots in patients with atrial fibrillation. Lines of conduction/blocking scar tissue are created on the heart using either radiofrequency or microwave energy. The conduction block interrupts the abnormal circuits that cause atrial fibrillation, enabling restoration of normal sinus rhythm. These minimally invasive approaches feature shorter procedure times, smaller incisions and a more rapid recovery. For more information, click here Minimally Invasive Surgical Ablation Approach.
The Cox Maze Surgical Procedure
Certain patients with isolated atrial fibrillation, especially continuous atrial fibrillation and/or enlarged atria, or after a failed catheter ablation are candidates for the Maze procedure. The Maze procedure can treat the atrial fibrillation and restore the atria to a more normal size. During the Maze procedure, the surgeon creates precise incisions in the right and left atria to interrupt the conduction of abnormal impulses. This allows sinus impulses to travel to the atrioventricular node (AV node) as they normally should. Patients who are not candidates for the traditional Maze procedure may be eligible for this modified Maze procedure. During this procedure, the surgeon uses an alternate energy source-radiofrequency, microwave, cryothermy or laser-to produce lesions and ultimately scar tissue to block the abnormal electrical impulses and promote the normal conduction of impulses through the proper pathway. For more information, click here Cox Maze Surgical Procedure.
Minimally Invasive Hybrid Ablation Procedure
The hybrid procedure may be used for patients with long-term atrial fibrillation, structural heart disease and those with an enlarged or growing left atrium. The hybrid procedure combines the techniques of electrophysiologists and cardiovascular surgeons in a single procedure. Using a special coagulation system, the surgeon creates a lesion pattern using radio frequency (extreme heat) on the outside of a beating heart without the need for chest incisions. In the same setting, an electrophysiologist uses an ablation catheter to complete the lesion pattern from inside the atrium of the heart and check that all currents which cause atrial fibrillation have been interrupted. This combination of a multidisciplinary approach allows for a more comprehensive and complete procedure because all available techniques and technologies of both disciplines are being used to ensure outcomes. For more information, click here Minimally Invasive Hybrid Ablation Procedure
For more information call (813) 877-AFIB (2342).