New Treatment for Patients with Isolated Atrial Fibrillation

Dr. Parvez Sultan of Cardio-Thoracic Surgeons has pioneered a new surgical procedure for atrial fibrillation that teams the surgeon with the cardiologist to combine two procedures into one that is less invasive and in most cases sends the patient home the next day.

Question: What is this new procedure called?

Dr. Sultan: It’s Hybrid Atrial Fibrillation, a new surgical technique that combines two procedures into one for the safety and wellness of the patient.

Question: So what was the old course of treatment?

Dr. Sultan: Previously what you used to do is the Electrophysiologist used to do an ablation going in through the groin and ablating the vein going all the way to the heart. They would map the areas where the abnormal rhythm was coming from. Then they would go in and scar those areas destroying the tissue. And, then we would come in and do something outside the heart in separate procedure. Now, this new procedure, which is done only for patients with an isolated atrial fibrillation, combines the procedures.

Question: Who is a candidate?

Dr. Sultan:  The best candidate is someone who is young, who has had an atrial fibrillation and failed medical therapy.

Question: Can you describe the new procedure?

Dr. Sultan: What we do as the surgeon is make a small incision in a hybrid O.R. or in the new EP lab at St. Vincent’s. We make a small incision below the sternum, go in and open the pericardium.  This is all done laproscopicly, and then we put in a small catheter behind the heart. What we do in fact is a basic burning of the epicenter and from there a normal rhythm starts.

Once we are finished, we close the patient up and then the cardiologist goes in through the groin, and starts ablating the veins to the heart, like what used to be done before. But, we add a different element to the procedure, a different value because the cardiologist could never fix everything before in one procedure. So now with this hybrid procedure, the surgeon and the cardiologist together we can do the procedures simultaneously.

Before, it was two separate procedures and the atrial fibrillation patient wouldn’t traditionally come to us — only if it was a case associated with an aortic valve or some other surgical issue.

Question: What are the benefits to the patient with this new procedure?

Dr. Sultan: Isolated atrial fibrillation was hard to treat because previously you had to open the chest up, but now you don’t have to do that. This procedure is minimally invasive. It is more appealing to the patient and to the cardiologist. And, best of all, the patient can go home the next day.