A Rejuvenated Heart

Surgical treatment for atrial fibrillation restores patient’s energy

Joe Timko figured he was just growing old, with a persistent heaviness in his chest that left him feeling sluggish. He didn’t realize he had atrial fibrillation (AFib), the most common heart rhythm disorder and one experienced unknowingly by millions of Americans.

AFib is caused by disorganized electrical impulses in the chambers of the heart. These uneven and often rapid impulses cause “quivering” in the atria and can leave a patient feeling like their heart is racing or even slowed down – and some people, like Joe, don’t feel it at all. This abnormality in the atria, or upper chambers of the heart, may prevent it from pushing enough blood into the ventricles, or lower chambers of the heart. Such sluggish blood flow means the heart isn’t pumping effectively, and can cause heart failure over time or blood clots that lead to stroke.

“AFib just wears your heart out,” says cardiac surgeon, Gregory Rushing, MD, who offers surgical ablation for patients with long-standing, persistent AFib that has lasted more than one year and who have failed other treatments.

A failing electrical system

AFib can present in a variety of ways. While irregular heart rhythms may be persistent or permanent for some patients, others may experience paroxysmal or intermittent AFib, which can occur suddenly, last seconds, minutes or even hours, and may resolve on its own. Paroxysmal AFib is actually no less concerning and can be dizzying and scary for a person unaware of what’s happening.

The majority of people with AFib don’t even know their heart is malfunctioning this way. They may go to a doctor for a check-up, or for a work-up before a procedure, and an EKG reveals their heart is in AFib. Joe just happened to learn about his AFib during a routine physician office visit. He had no idea the heaviness in his chest and unexplained fatigue was the result of AFib.

“Actually, when heart palpitations are not present, the majority of patients’ symptoms are not attributed to the heart,” says Dr. Rushing. “They show up at their doctor’s office for a cholesterol evaluation, or to get ready for a colonoscopy, and AFib is an incidental finding.”

Surgical ablation uses either heat or cold energy to electrically isolate the tissue of a small part of the heart to stop its quivering.

Surgery takes two forms: either traditional open heart surgery, or a newer minimally invasive approach, in which surgeons use special cameras and catheters to ablate or correct AFib using small incisions. Minimally invasive surgical ablation is safe and has an 85 percent success rate, Dr. Rushing said. As long as the patient has not undergone previous cardiac surgery, they may be a candidate.

“This is not an option for patients who have already had heart surgery due to scar tissue,” he added. “For those patients, open heart surgery is the only option.”

Tackling AFib with Surgery

In minimally invasive surgical ablation, the cardiac surgeon uses a thoracoscope, a long scope with light and camera, to view the outside of the heart. A flexible catheter is used to ablate or “burn” the top chambers of the heart. This minimally invasive procedure involves only an overnight stay in the hospital and a few weeks of recovery.

This minimally invasive thoracoscopic epicardial ablation has a high success rate. Just ask Joe.

“I run up and down the steps now,” said Joe, now 72. “I feel I can do almost anything again.

“I had felt old, like this was the way I was going to be the rest of my days, sitting in my recliner watching TV. Now, if you ask me to do something, I’ll say, ‘Let’s go.’ I have energy I didn’t even realize I was missing.” Some AFib patients do not respond well to medical therapies or have other health conditions that make long-term blood thinner use inadvisable, even dangerous. For these patients, the atrial fibrillation specialists at University Hospitals Harrington Heart & Vascular Institute offer the full range of surgical and nonsurgical treatment options. Learn More.