Atrial fibrillation (AF) is the most common heart rhythm disturbance and carries significant cardiovascular morbidity and mortality. Due to the loss of co-ordinated contraction within the atria, static blood increases the risk of clot and therefore stroke. Medical therapy such as anti-arrhythmic and blood thinning drugs are used to treat AF. Surgical treatment for AF has developed rapidly over recent years and performed secondary to another cardiac surgical procedure.
Under a general anaesthetic (GA), the operation is usually performed through a mid-line incision. This is usually performed on cardiopulmonary bypass (CPB) that takes over the oxygenation of blood re-directed during surgery. The primary surgical procedure is performed and then your surgeon will treat your mechanism for AF.
Pulmonary Vein Isolation (PVI)
If you have intermittent episodes of AF and are under going cardiac surgery, then your surgeon may perform pulmonary vein isolation (PVI) in addition to your primary cardiac surgery All four of the pulmonary veins in the left atrium are electrically isolated using an ablative technology that will aim to prevent AF in the future.
Left atrial appendage excision
The left atrial appendage sits on the left atrium and has been identified as a structure that can collect clot in patients with AF. In addition to your primary cardiac surgery, your surgeon may decide to excise your left atrial appendage to minimise the risk of future atrial thrombus and thrombo-embolic events that may lead to stroke.
Your surgeon will discuss with you what treatment for AF is most appropriate prior to your surgery. The chest is then closed and you are transferred to the Intensive Care Unit (ICU) for observation.
Following ICU, you will be transferred back to your single room. Nurses and physiotherapists will aid your recovery until you are fit and confident enough to return home. This usually takes 5-6 days.