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Treating Heart Arrhythmias With Ablation

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What Can I Expect During Surgical Ablation?

During surgical ablation, you can expect the following:

  • General anesthesia (the patient is asleep) or local anesthesia with sedation (the patient is awake but relaxed and pain-free) may be used, depending on the individual case.
  • During minimally invasive surgery, the surgeon views the outer surface of the heart using an endoscope. Specialized instruments are used to locate the areas needing ablation and to create the lines of conduction block. Unlike traditional heart surgery, there is no large chest wall incision, and the heart is not stopped.
  • The Maze procedure requires an incision along the sternum (breast bone). The incision may be traditional (about 6 to 8 inches long), or in some cases, minimally invasive (about 3 to 5 inches long). The patient is asleep and the heart is stopped during this procedure. A heart-lung machine oxygenates the blood and circulates it throughout the body during surgery.
  • The modified Maze procedure involves using one of four different energy sources to create the lines of conduction block (radiofrequency, microwave, laser, or cryothermy). The energy probe of choice is inserted, and under direct vision, used to create the lesion lines. As in the classic Maze procedure, these lesions create lines of conduction block that interrupt the abnormal impulses and restore the normal sinus rhythm. This procedure is used primarily in patients who have atrial fibrillation and other indications for cardiac surgery.

What Happens After Surgical Ablation?

If your ablation surgery was combined with valve, bypass, or another surgical procedure, your post-procedure care may be different.

After surgical ablation:

  • The patient is usually transferred to an intensive care unit (ICU) for close monitoring for about one to two days after the surgery. When the patient's condition is stable, he or she is transferred to a regular nursing unit (called a telemetry unit).
  • The monitoring during recovery includes heart, blood pressure, and blood oxygen monitoring and frequent checks of vital signs and other parameters.
  • Most patients stay in the hospital about 5 to 7 days after the procedure, depending on their rate of recovery. Patients who had minimally invasive surgery may be able to go home 2 to 3 days after surgery. Your health care team will follow your progress and help you recover as quickly as possible.
  • Full recovery from surgery takes about 6 to 8 weeks. Most patients are able to drive in about 3 to 8 weeks after surgery. Your health care team will provide specific guidelines for your recovery and return to work, including specific instructions on activity, incision care, and general health after the surgery.
  • Many patients may experience skipped heartbeats or short episodes of atrial fibrillation during the first three months after the procedure. This is common due to inflammation (swelling) of the heart tissue and is treated with medications. After the heart has healed, these abnormal heartbeats should subside.
  • A small number of patients require a pacemaker after surgery due to an underlying abnormal rhythm which previously was undetected.
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