1st in IL to Perform Surgery to Treat Abnormal Heart Rhythm
Minimally Invasive “Mini-Maze” Surgery Treats Atrial Fibrillation and Reduces Risk of Stroke
Winfield, Ill., June 23, 2005 – Central DuPage Hospital has recently performed a revolutionary new surgery – twice – that corrects atrial fibrillation (AFib or AF), a common form of heart rhythm abnormality and a major cause of stroke. The procedure, called Mini-Maze because of its minimally invasive nature, offers new hope to AF patients for whom no reliable cure now exists.
“For the first time we have a reliable, truly minimally invasive procedure that can permanently eliminate AF without long term side effects or great surgical stress to the patient,” said Marc Gerdisch, MD, director of cardiothoracic surgery at Central DuPage Hospital. “This treatment has the potential to help many of the people who suffer from AF, returning them to normal rhythm and significantly reducing their risk of stroke.”
The procedure is performed through small incisions without dividing bone or spreading ribs. “This is a substantial advancement over what we have been able to do in the past. Although we had been performing the procedure on the beating heart, division of the breastbone was required,” explained Dr. Gerdisch.
AF is an irregular heart rhythm that compromises the heart’s ability to pump blood. Abnormal electrical signals begin at the top of the heart and travel down the muscle, causing the atria, or upper chambers, to contract erratically. As a result, blood pools in the atria and forms clots that can travel to the brain and cause stroke.
The success of the Mini-Maze could not be judged until the first patient was able to wean himself completely from the medication that had kept his AF in check. The first patient, a 70-year-old man (who wishes to remain anonymous) from DuPage County, underwent the mini-Maze in January, 2005, and now, after five months, that patient is enjoying a new, active lifestyle—free of the complications of medication and the physical restraints of AF. Dr. Gerdisch recently performed (June 20, 2005) the second such Mini-Maze at Central DuPage Hospital.
“I am glad to have the opportunity to be one of the first to get this mini-maze procedure because major surgery simply was not an option, I couldn’t risk a long, slow recovery,” explains Ed Edwards, a 55 year-old man from Naperville, Ill. “I have my own business and I am an avid golfer. I simply can not afford to slow down—this procedure will allow me to recapture a productive and active pace. Knowing that my heart won’t go out of rhythm when I exercise removes a tremendous amount of anxiety.”
A Zone Defense
Mini-Maze surgery is based on a proven approach to treating AF that involves interrupting the path of the aberrant electrical impulses, thereby restoring normal atrial contraction. To perform the procedure, heart surgeons only need make small openings between the ribs, through which the thoracoscope and Atri-Cure device is inserted into the thoracic cavity. With the help of a small fiber optic camera to guide them, surgeons grasp the atrium with the Atri-Cure tool, encircling the top of the chamber. The surgeon uses radiofrequency (RF) technology to destroy a small amount of tissue in the area near where the irregular impulse starts. The damaged tissue can no longer conduct electrical impulses, interrupting the transmission of the abnormal signal and allowing the rest of the chamber to resume beating normally. A series of maze-like pathways are created using this process.
This is the first procedure of its kind performed in Illinois. Experience to date indicates that Mini-Maze surgery eliminates AF in more than 85 percent of patients who undergo the procedure. Randall Wolf, MD from University Hospital in Cincinnati pioneered the procedure and personally instructed Dr. Gerdisch on the Mini-Maze, sometimes called the Mini-Wolf. Atri-Cure manufactures the device Gerdisch and Wolf use to deliver the RF signal.
“By isolating the zone where the arrhythmia originates, we keep the rest of heart from being affected,” Dr. Gerdisch explained. “We’ve known for some time that this can be an effective strategy for treating AF, but until now we haven’t had the tools to do it easily.”
The Mini-Maze technique is being used in two ways. For patients who suffer from AF alone, the procedure is done in a minimally invasive way. In this approach, doctors perform the entire operation through a small incision between the ribs. For patients who require surgery for other types of heart condition, for example, heart valve replacement or coronary bypass, the AF treatment can be incorporated into these common heart operations.
“This is a very significant advance for treating AF. We can now offer many patients a minimally invasive procedure to permanently correct their condition,” said Dr. Gerdisch. “For patients who must undergo traditional heart surgery for other reasons, we can correct their AF during the same operation. Together, these options give us great flexibility to treat a large number of patients with this disease.”
Need for Better Treatment
AF is the most common form of arrhythmia, an irregularity in the normal rhythm of the heartbeat. According to the American Heart Association, approximately 2.2 million people in the United States suffer from AF and more than 300,000 new cases are diagnosed each year. The condition carries serious consequences. AF increases the risk of stroke fivefold, and is a major contributor to the development of congestive heart failure.
AF is now most often treated with anticoagulant drugs, which do not address the abnormal heart beat but instead are used to prevent the formation of blood clots. These clots, which form when blood stagnates and pools in the poorly functioning atria, account for the high risk of stroke in patients with AF. Lifelong anticoagulant therapy is necessary, but these drugs increase the risk of bleeding and require frequent blood tests to ensure that the level of medication is the right range.
Other treatments, including catheter-based procedures and older forms of surgery, are available to correct the abnormal rhythm of AF but these are infrequently used because they are highly invasive, difficult to perform or carry significant risk and appear to be less effective.
“Until now, the options available to AF patients were unattractive at best. They could be on anticoagulant therapy for the rest of their life, have a permanent pacemaker or undergo a very difficult operation,” Dr. Gerdisch said. “With Mini-Maze, we can offer patients a much better choice.”
About Central DuPage Hospital
Central DuPage Hospital is a 361-bed facility located in Winfield, Illinois, a suburb of Chicago. The hospital is a leading center for surgical innovations and was one of the first institutions in the nation to offer minimally invasive heart surgery, as well as a new procedure for back surgeries that uses bio-engineered bone protein.
Central DuPage Hospital is part of Central DuPage Health, a network including convenient care centers, occupational health services, and a full range of options for senior living, home health and hospice care. For additional information, please visit www.cdh.org.