Surgery

In some cases, a doctor will recommend surgery to treat arrhythmias, usually after other options have failed to work. Several procedures are used, depending on the type of arrhythmia and other heart problems. The types of surgery include:

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• Maze procedure: This complex surgical procedure performed at only a handful of medical centers, to treat atrial fibrillation by creating barriers to electrical pathways in the heart. Because the maze procedure is an open heart operation, it's usually reserved for patients whose atrial fibrillation has not been resolved using medication, patients whose symptoms interfere with their quality of life, patients at high risk for blood clots or stroke, and patients already undergoing heart surgery to resolve other conditions.
  
  During the procedure, which takes about three hours to complete, the surgeon makes several lesions in the atria. The lesions can be made using a scalpel to cut the tissue, a radio-frequency device to destroy the tissue with heat, or a cryoablation device to destroy the tissue through freezing. When healed, the incisions form scars that create an intricate pattern or maze that directs the electrical activity in the heart. This maze allows the heart to restore a regular coordinated heartbeat.
  
  Full recovery from the maze procedure usually takes about two to three months, with the first one to two days spent in the intensive care unit of the hospital. Most patients spend a total of five to seven days in the hospital. During this time, your doctor may prescribe diuretics to remove excess fluid and/or aspirin to minimize the potential for blood clots to form.
  
  The maze procedure can be very effective for patients with atrial fibrillation; up to 95 percent of patients undergoing the maze procedure at experienced medical centers have no atrial fibrillation at discharge. For the remaining patients, follow-up drug therapy can improve their atrial fibrillation.
  
  New technology, the minimal access catheter maze procedure, is faster, safer and less invasive than the open-heart maze procedure. Surgeons access the heart through the chest wall using catheters guided by a small camera called a thoracoscope. Cyroablation is used to freeze the abnormal tissue to block unwanted electrical pathways in the heart.
  
  The success of minimal access catheter maze procedure at controlling tachycardia largely depends on the part of the heart involved and the follow up treatment. At experienced centers, the success rate approaches 70 percent to 80 percent, with many of the remaining patients benefiting from medication therapy.
• Ventricular aneurysm surgery: After a heart attack or other damage is done to the heart, the ventricular wall may weaken, become thin, and balloon out to form an aneurysm. Usually occurring in the left ventricle, the main pumping chamber of the heart, ventricular aneurysms are relatively rare and potentially dangerous because the localized weakening increases the workload on the heart and increases the likelihood of arrhythmias. Surgically removing this thinning wall may be necessary to correct the arrhythmia.
• Coronary bypass surgery: People with severe coronary artery disease and ventricular tachycardia may be helped by coronary bypass surgery. In this procedure, blood flow is rerouted around the clogged or diseased section of artery. This improves blood flow to the heart, which helps reduce the incidence of tachycardia.