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Maze & Mini-Maze Surgeries

Lorrie’s Catastrophic Mini-Maze Surgery and Its After-Math

Lorrie was an informed Atrial Fibrillation patient. She did everything right.

Lorrie C.

She researched her disease, she studied the choices of surgical treatments. With input from her EP, she thoughtfully decided on a Mini-Maze surgery.

She chose a highly skilled cardiac surgeon with an outstanding reputation. She and a companion interviewed the surgeon and asked loads of questions—twice. And chose one of the top 100 hospitals in the country for her surgery.

It’s a shame she had to endure so many complications.

The first part of Lorrie’s Atrial Fibrillation story was written in 2012 from her hospital room upon re-admission after Mini-Maze surgery. She then jumps to the present and writes about the aftermath. She begins:

“As I sit in my hospital bed on my seventh consecutive day of my second admission, I have finally mustered the strength and clarity of mind to write about my exasperating experience of an elective surgery… .
My A-Fib started when I was in my early 60’s with only a few episodes a year. The story of my Mini-Maze surgery began about four years later when my electrophysiologist felt it was time to put an end to my increasing episodes of Atrial Fibrillation.
Due to having paroxysmal A-Fib (meaning every now and then for unknown reasons) as well as my good health and stamina, at 66 years of age I was the perfect candidate for either a catheter vein ablation or Mini-Maze surgery. Because I was only having about 3 episodes a year and in good health, my EP felt that I would have a success rate of over 95%.
After much research, I decided the Mini-Maze would be the best procedure for me. (My EP felt it would be a better choice than an ablation, for he felt I would have a good outcome, which I did not.)
He also warned me that the Mini-Maze wouldn’t be a “walk in the park.” That was an understatement! …

…Continue reading Lorrie’s story about her mini-maze surgery and learn her advice to others with A-Fib.

Atrial Fibrillation and a Catastrophic Mini-Maze Surgery

By Lorrie C., August 2020

Lorrie C.

The first part of Lorrie’s Atrial Fibrillation story was written in 2012 from her hospital room upon re-admission after Mini-Maze surgery. She then jumps to the present and writes about the aftermath.

As I sit in my hospital bed on my seventh consecutive day of my second admission, I have finally mustered the strength and clarity of mind to write about my exasperating experience of an elective surgery.

My A-Fib Gets Worse

My A-Fib started approximately 10 years ago when I was in my early 60’s with only a few episodes a year.

The story of my Mini-Maze surgery began about four years later when my electrophysiologist felt it was time to put an end to my increasing episodes of Atrial Fibrillation. (Atrial fibrillation, or A-Fib, is an irregular heart rhythm caused by the quivering of heart muscles of the atria.)

Years ago, many physicians regarded A-Fib as “just a nuisance.” It is now known that clots form during an episode and may cause a stroke when the patient returns to a normal sinus rhythm.

As one grows older, the A-Fib episodes can become more frequent and stretch the atria. Once it stretches beyond the criteria for surgical correction, there is nothing more that can be done, and the patient may eventually suffer from persistent A-Fib and simply have to live with the feeling of “squirrels in the chest.”

Catheter Ablation or Mini-Maze?

Due to having paroxysmal A-Fib (meaning every now and then for unknown reasons) as well as my good health and stamina, at 66 years of age I was the perfect candidate for either a catheter vein ablation or Mini-Maze surgery. Because I was only having about 3 episodes a year and in good health, my EP felt that I would have a success rate of over 95%.

With both the catheter ablation and the Mini-Maze, the electrophysiologist or cardiothoracic surgeon creates lesions by cauterizing around the pulmonary veins to hopefully stop [interrupt] the erratic electrical signals which cause A-Fib.

After much research, I decided the Mini-Maze would be the best procedure for me. (My EP felt it would be a better choice than an ablation, for he felt I would have a good outcome which I did not.)

About Mini-Maze Surgery

As I understand it, three incisions are made under the arm on each side of the chest.  The lungs are somewhat deflated, and the surgeon has a clear view of the heart to see exactly where the lesions are being made.

My EP told me he would be there to do mapping. (Whether he was for sure or not, I do not know. I can only assume he was.) [It is not standard practice for an EP to be present during a Mini-Maze surgery.]

One advantage of the Mini-Maze over a catheter ablation is that the left atrial appendage, where most clots form, is stapled off thereby reducing the risk of stroke by 80%.

For more about the Mini-Maze, see my article:“When to consider a Mini-Maze surgery instead of a Catheter Ablation?” 

Warned that Mini-Maze Won’t be a “Walk in the Park”

My electrophysiologist agreed with my decision, although he warned me that the Mini-Maze wouldn’t be a “walk in the park.” That was an understatement!

I chose a well-known cardiothoracic surgeon from a very well-known hospital to perform my surgery and hopefully end my A-Fib forever.

Interviewing the Surgeon―Many Questions

My daughter, Lisa, accompanied me to my initial visit, and we were both armed with questions. When I asked the surgeon, what were the risks of the surgery, he said the two major risks were phrenic nerve damage or bleeding.

We questioned him vigorously, and he was very patient answering all questions. He said I would be “in and out of A-Fib” for the first two or three months due to inflammation. I am sorry to say the one thing we didn’t ask was what complications could be encountered during or after the surgery.

To be sure I was making the right decision, I met with the surgeon a second time and drilled him again. He said his success rate was 80%; however, I would most probably be in the 90% and above bracket.

Selecting a cardiac specialist can be a daunting task, to learn how, see our page: Finding the Right Doctor for You and Your A-Fib.

The Day of My Mini-Maze Surgery Arrives

My Mini-Maze was performed on September 1, 2012, at one of the top 100 hospitals in the country with one of the best cardiothoracic surgeons at the helm. Contrary to what my electrophysiologist had warned, I was confident this surgery would be a “walk in the park.”

The surgery took approximately 4 ½ hours. My husband and my friend anxiously awaited the results from the surgeon. He told them my surgery went perfectly, and that I was doing very well.

My Recovery―Three Days in the Hospital

I spent the first day in the Intensive Care Unit on heavy duty pain meds as well as a nerve block, so I don’t remember much the first couple of days.

I vaguely remember the surgeon telling me I developed fluid around the outside of my right lung, but it would probably be absorbed. If not, I would have to come back to the hospital to have a drain tube inserted and stay overnight.

On the third day after the surgery, I had an eight-hour episode of A-Fib (which was to be expected).

I was discharged on the sixth day and was delighted to be home again.

Back Home, but Daily A-Fib Episodes―Breathing Problems

Much to my disappointment, I began to experience daily A-Fib episodes lasting anywhere from eight hours up to twenty hours. I knew this was to be expected, but it could not be happening to me―after all, I am Super Woman!

My breathing began to worsen, and I had to move my post op visit up a week.

After a chest x-ray and exam, the surgeon told me I had to be re-admitted to the hospital.

Post-Surgery Visit Sooner Than Planned

After having a chest x-ray and an examination, the surgeon told me I had to be admitted the next day to have a drain tube inserted – the fluid around my right lung was not being absorbed and had to be drained.

The fluid was causing a pneumothorax (collapsing of the lung) and that was the reason I was so short of breath. (Complication #1)

Re-Admitted to Hospital

Drainage Tube Inserted: I was admitted to the hospital and the chest tube was inserted…but without anesthetic. And let me tell you, it was the most painful experience next to childbirth!  (Complication #2) That evening, a CT scan of the chest was done to see if there was proper placement of the drain tube. The CT revealed something that I was not prepared for….

Undisclosed Fractured Rib: The next morning, my husband and I were taken aback when the surgeon told us he had fractured a rib during the surgery and he had removed a portion of the middle of my rib, then stitched muscle in place to fill the gap.

…and a Lung Hernia: He explained that after surgery, my excessive coughing tore those stitches. I now had a hernia that had to be surgically repaired as soon as the lung surgeon was available. (The hernia was my lung popping out of the space where the piece of rib had been removed!)  (Complication #3)

Fortunately, when the lung surgeon viewed my CT and examined me, he didn’t feel emergency surgery was necessary, for he said it was a small hernia and it may repair itself. [If not, and it became worse or bothered me, he could do the repair, but it was not an emergency.

My overnight stay became a week due to going in and out of A-Fib.

Overnight Stretches to a Week in the Hospital: My overnight stay became a week due to going in and out of A-Fib. I was on Coumadin and waiting for my INR to be at a therapeutic level so I can be discharged.

Home, Sweet Home

Cellulitis from Infected IV: It has been difficult writing this saga in long hand, for I have developed cellulitis [red, swollen, bacterial skin infection] in my right hand from an infected IV.  (Complication #4)

…and a Respiratory Tract Infection: I am now at home, still coughing away. It’s due to an upper respiratory tract infection I caught the first couple of days in the hospital. (Complication #5)

Thankfully, the cellulitis is much improved, and I am able to type my story as I am going in and out of A-Fib.”

Fast-Forward to 2020: The After-Path of a Catastrophic Surgery

Today, I have no A-Fib episodes. I still go into atrial tachycardia [the atria beats too quickly] and have frequent PVC’s [extra heartbeats from a ventricle] and bradycardia.[slower than normal heart rate].

No doctor has said anything about my lung hernia. I assume once you have one, it will always be there unless you have surgery.

Another result of my mini-maze was paralyzed diaphragm [from surgical trauma, causes reduction in lung capacity]. I still have some shortness of breath from the paralyzed diaphragm “but it’s something I can live with.”

When I was in A-Fib before, I was very symptomatic. I dread the time, if I discontinue amiodarone, that my A-Fib will return.

That, along with my right lung being raised above my left lung. It was not like that before the surgery and the surgeon could not explain why.

I still take a low dose of amiodarone (200 mg). I do know the dangers of amiodarone, and I do have had some thyroid issues. But my EP and cardiologist monitor my labs for the effects and feel the low dose is okay for me.

Lessons learned about life with A-FibLesson Learned

My advice to other A-Fib patients? Due your homework. Get second opinions.

About choosing a Mini-Maze vs Ablation? Listen to the advice of your doctor, but always get a second opinion.

Make sure the surgeon has done a lot of this type of surgery. My surgeon was a prominent, skilled heart surgeon, but I don’t believe he had much experience in performing the mini-maze. (At the time this surgery was not yet popular in my geographical area.)

And finally, if you are going to have any type of surgery, please ask your surgeon what “complications” you may encounter, not just the risks.

Thank you for reading!
Lorrie C.

Editor's Comments about Cecelia's A-Fib storyEditor’s Comments

Lorrie was an informed patient. She did everything right.
To find A-Fib specialists in your area or country, see A-Fib.com Directory of Doctors and Facilities 
She researched her disease, she studied the surgical treatments. She thoughtfully chose to have a Mini-Maze surgery. She chose a highly skilled cardiac surgeon with an outstanding reputation. She and a companion interviewed the surgeon and asked loads of questions—twice. And chose one of the top 100 hospitals in the country for her surgery. It’s a shame she had to endure so many complications.
I Don’t Understand: Why didn’t the surgeon tell Lorrie’s family that he had fractured and perforated her rib during the Mini-Maze? That’s a long-term complication that could affect Lorrie for years and cause major, lasting pain.
It’s hard to comprehend why on her re-admission, the surgeon used no anesthetic when he inserted the drainage tube into Lorrie’s chest. It’s also unusual for Lorrie to have so many A-Fib attacks right after her Mini-Maze.  
Caution: Mini-Maze Not Recommended for First Timers. In general, catheter ablation is recognized in current guidelines as a first option treatment for A-Fib (Class IIa). Whereas surgical treatments such as the Mini-Maze are generally not a first option (Class IIb), (The exception is special circumstances such as intolerance to anticoagulants.)
I admit it! I’m biased toward catheter ablation for the majority of A-Fib patients.

It’s less traumatic and you are often home the same day or the day after. And it can be repeated, if needed.

Mini-Maze Surgery has Limitations: The standard Mini-Maze only isolates the Pulmonary Veins (PVs). If you have A-Fib signals coming from other parts of the heart untreatable by a Mini-Maze (such as Flutter from the right atrium), you’ll need a catheter ablation with advanced mapping to find and isolate these A-Fib spots.
Is Mini-Maze Really “Minimally Invasive”? To the average patient, a Mini-Maze is still heart surgery with the potential risks and complications. On the upside, more surgeons now are accessing the heart less invasively through the diaphragm rather than through the ribs as in Lorrie’s case. But it’s still not a “walk in the park.”
Ablation vs. Mini-Maze Trial: There are few clinical trials comparing the Mini-Maze to Catheter Ablation. One was the SCALAF trial which found that patients undergoing the Mini-Maze had nearly a one-in-four chance of having a major complication (unacceptable for most patients). To learn more, see my article: Catheter Ablation vs Surgery For A-Fib: Finally an Apples-to-Apples Comparison.  
Controversy about Removal of Left Atrial Appendage (LAA): Lori mentioned that the Mini-Maze surgery includes removal of the LAA. The LAA is not a useless appendage. Some medical professionals question the need of removing the LAA if the goal of the surgery is to no longer be in A-Fib. To learn more, see my article: The Role of the Left Atrial Appendage (LAA) & Removal Issues.
Dangers of Long-term Amiodarone: While Amiodarone is the most effective of the antiarrhythmic drugs, it’s also the most toxic. Normally people are on Amiodarone for only a few months or less. To learn more see: Amiodarone: Most Effective and Most Toxic. And especially this tragic, heartbreaking story of a doctor who died on Amiodarone: Toxic Effects of Amiodarone—What Could Have Prevented this Death?
Thank you, Lorrie! We are grateful to Lorrie for sharing her cautionary tale about the possible complications of Mini-Maze surgery.

Learn about sharing your A-Fib story

Return to: Personal A-Fib Stories

If you find any errors on this page, email us. Y Last updated: Saturday, August 22, 2020

 

VIDEO: The Hybrid Maze/Ablation for Atrial Fibrillation for Persistent A-Fib

For persistent or long-standing persistent atrial fibrillation, the Hybrid Maze/Ablation (also called the Hybrid Convergent Procedure) combines the complementary efforts of both the cardiothoracic surgeon and the cardiac electrophysiologist. The surgeon works on the outside the heart and the EP on the inside of the heart to eliminate the Atrial Fibrillation signals.

In this video, two cardiac EPs and a cardiothoracic surgeon describe the advantages, safety and effectiveness of the Hybrid approach and who is a good candidate. Includes animation and on-camera interviews.

Published by Tenet Heart & Vascular Network. Length 4:30. 

YouTube video playback controls: When watching this video, you have several playback options. The following controls are located in the lower right portion of the frame: Turn on closed captions, Settings (speed/quality), Watch on YouTube website, and Enlarge video to full frame. Click an icon to select.

If you find any errors on this page, email us. Y Last updated: Tuesday, July 17, 2018

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Wondering if you Should Consider a Cox Maze or Mini-Maze for your A-Fib?

What are your options when drugs aren’t working or you can’t tolerate them? When your symptoms are impacting your quality of life? And you want to cure your A-Fib not just manage it? Treatment options to consider include Catheter Ablation or Maze or Mini-Maze surgeries.

We’ve published a new FAQ question and answer about the Maze or Mini-Maze surgeries:

Surgical Maze pattern of series of lesions

“When should A-Fib patients consider a full Cox Maze or a Mini-Maze surgery instead of a Catheter Ablation?”

In general, candidates for Maze or Mini-Maze surgeries are patients with significant, frequent A-Fib symptoms that do not respond to medication or catheter ablation. Patients who are unaware of their A-Fib symptoms are probably not candidates. However, each case is unique, so it’s best to discuss your options with your cardiologist.

There are several specific circumstances in which you might consider a Maze surgery…continue reading our answer…

FAQ: When to Consider the Maze/Mini-Maze Surgery for Atrial Fibrillation

FAQ: Maze Surgeries

“When should A-Fib patients consider a full Cox Maze or a Mini-Maze surgery instead of a Catheter Ablation?” 

Surgical Maze pattern of series of lesions; used with permission Nature Publishing Group

Surgical Maze pattern of series of lesions

There are several specific circumstances in which you might consider a Maze surgery:

• You are having other heart-related surgery. If you have to undergo open heart surgery for another heart problem, such as a Mitral Valve replacement, the Cox Maze operation can be performed concurrently with your other heart surgery.

• You don’t qualify for a catheter ablation. If you can’t take blood thinners, for example, you can’t have an ablation.

• You’ve already had a stroke. Or you are in danger of having a stroke during a catheter ablation.

• You’re morbidly obese. It’s more difficult to see a clear image of the heart with current imaging systems during a catheter ablation if someone is significantly overweight.

A word of caution—the Maze/Mini-Maze are surgical operations with the potential risks and complications of surgery.
Maze incisions

Typical Mini-Maze incisions for surgical ablation of A-Fib

Current Guidelines for the Management of Patients with A-Fib

Surgery isn’t recommended as a first choice by current A-Fib treatment guidelines. The Maze surgeries are more invasive, traumatic, risky and with longer (in hospital) recovery times.

In general, candidates for Maze or Mini-Maze surgeries, are patients with significant, frequent A-Fib symptoms that do not respond to medication or catheter ablation. Patients who are unaware of their A-Fib symptoms are probably not candidates.

However, each case is unique, so it’s best to discuss your options with your cardiologist.

Find the Right Doctor

To find the right electrophysiologist (EP) for you, see Finding the Right Doctor for You and Your A-Fib.

Resource for this article
2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology, Volume 64, Issue 21, December 2014. DOI: 10.1016/j.jacc.2014.03.021. http://www.onlinejacc.org/content/64/21/2246.

Catheter Ablation vs Surgery For A-Fib: Finally an Apples-to-Apples Comparison

Update July 27, 2018 Which is better from a patient’s perspective―Catheter Ablation or Surgery (Mini-Maze)? A new study compares the two head-to-head.

An article in Cardiac Rhythm News (no author), describes the SCALAF trial (Surgical vs. Catheter Ablation of paroxysmal and early persistent Atrial Fibrillation).

SCALAF Trial Design

The SCALAF study is the first randomized control trial of patients with symptomatic A-Fib. In a 1:1 ratio, 52 patients received either a catheter ablation or surgery as their first invasive procedure. Follow-up data in all patients was collected for 2 years using implantable loop recorders (Medtronic Reveal XT).

The measurement of success was freedom from A-Fib (atrial tachyarrhythmia) and off antiarrhythmic drugs with safety measured by procedure-related complications.

PV Isolation Direct Comparison: The catheter ablation arm only isolated the PVs without additional lesion sets. The surgical arm (Mini-Maze) only isolated the PVs (and removed the left atrial appendage).

Trial Results

Efficacy: Catheter ablation vs. surgical patients (60% vs. 27%) were free from A-Fib without drugs.

Efficacy: After 2 years, a significantly greater number of catheter ablation patients (60%) were free from A-Fib without having to take A-Fib drugs compared to a much smaller number of surgical patients (27%).

Safety: Surgery patients had a higher procedure-related complication rate (34.8% vs. 11.1%) and a higher rate of major complications (22% vs. 0.0%) compared to catheter ablation patients. That’s about 1-in-4 surgical patients who had significant complications.

Safety: Surgery patients had a higher procedure-related complication rate (34.8% vs. 11.1%).

Hospital Stay: Hospitalization was longer for surgical patients with an average hospital stay of nine (6–10) days compared to three (2–3) days for catheter ablation.

Trial Conclusions

The investigators concluded that catheter ablation of the PVs in the treatment of paroxysmal and early persistent A-Fib is safer and results in higher long-term arrhythmia free survival compared to surgical (Mini-Maze) PV isolation. Follow-up with continuous monitoring using implantable loop recorders was important for true and accurate outcomes.

What Patients Need to Know

Don’t Make Surgery Your First Choice: Following the 2014 Guidelines for the Management of Patients with Atrial Fibrillation, your first treatment option should not be surgery (Mini-Maze).

Catheter Ablation Higher Success and Safer: Though this was a small study, this trial showed that catheter ablation is safer with better long-term freedom from A-Fib (and without medication) when compared head-to-head with surgical Mini-Maze. Follow-up monitoring of each patient with an implantable loop recorder (for 24/7, 365 days for two years) produced unbiased, non-disputable results.

The 2011 FAST Trial: The SCALAF trial results might be compared to the 2011 FAST Trial sponsored by AtriCure, Inc. The FAST trial compared AtriCure’s own system for Mini-Maze surgery to catheter ablation. The results favoring surgery don’t hold up under close scrutiny. More important was the high complication rate of the surgical approach. For more, see Surgical Versus Catheter Ablation―Flawed Study.

SCALAF: Catheter ablation is safer with better long-term freedom from A-Fib (and without medication) when compared head-to-head with surgical Mini-Maze.
The Bottom Line: We now have an unbiased clinical trial comparing catheter ablation with surgery.

According to the SCAFAL trial, catheter ablation has higher success for long-term freedom from A-Fib than the surgery approach. Just as important, data from both FAST and SCAFAL demonstrate that catheter ablation is much safer than surgery.

Update July 27, 2018: In response to this post about the SCAFAL trial, we received this statement from surgeon Dr. John H. Sirak who performs the “5 box surgery” for A-Fib. Especially relevant is his statement that surgical PVI alone tends to produce Flutter. (The FAST study did compare more complex surgeries to catheter ablation.)

“I must be direct and say this study is next to worthless. First, it isn’t clear how the cohorts compare in terms of AF chronicity. Surgical PVI should at least be no worse than percutaneous. PVI is the most foolproof step of a surgical maze. If the randomization were truly accurate, why was the surgical arm so much smaller? My suspicion is that the surgical arm had a significantly higher number of non-paroxysmal patients. And who were the orangutans operating with a 35% complication rate? Along the same lines, since surgical PVI alone is now widely known to be fluttergenic and thus contraindicated, no reputable surgeon would offer a patient such an outdated operation! This study is not only pathetically executed, but also has no relevance to current standard-of-care practice.”
-Dr. John H. Sirak

Resources for this article
• Surgical treatment of atrial fibrillation results in higher complication rates when compared to catheter ablation. Cardiac Rhythm News (no author). May 18, 2018, Issue 41, p. 9.

• Surgical or Catheter Ablation of Lone Atrial Fibrillation (AF) Patients (SCALAF). ClinicalTrials.gov Identifier: NCT00703157. Sponsor: Medtronic Bakken Research Center Note: Principal Investigators are NOT employed by the organization sponsoring the study. https://clinicaltrials.gov/ct2/show/results/NCT00703157.

• AHA/ACC/HRS 2014 Guideline for the Management of Patients With Atrial Fibrillation. Circulation. published online March 28, 2014, 4.2.1. Antiplatelet Agents, p 29.doi: 10.1161/CIR.0000000000000041 Last accessed Nov 23, 2014.URL: From http://content.onlinejacc.org/article.aspx?articleid=1854230

New Video: The Maze Open-Heart Surgery From The Cleveland Clinic

In a new video we’ve added to our library, cardiac surgeon Edward Soltesz, MD, discusses who is a good candidate for the Maze surgical-based treatment for Atrial Fibrillation.

Image from the video ‘The Maze Open-Heart Surgery’

The full Maze open-heart surgery is typically performed in conjunction with surgery to correct another heart condition such as valve disease or coronary disease but can also be performed as a standalone treatment.

Interviews, animation, illustrations and surgical footage. (3:19) Produced and posted by the Cleveland Clinic. Go to video->

Related Videos: Mini-Maze Surgery

You may also be interested in our videos about the Mini-Maze:

Mini-Maze Ablation for Persistent A-Fib: With Cardiac Surgeon Dr. Dipin Gupta
In-Depth: Mini-Maze Surgery: Inside the O.R. with Dr. William Harris, Cardiovascular Surgeon

A-Fib Library of Videos and Animations

We have carefully selected the A-Fib-related videos in our Video Library. They have been selected for the reader who learns visually through motion graphics, audio, and personal interviews.

Our collection of short videos are organized loosely into three levels: introductory/basic, intermediate and in-depth/advanced. Click to browse our video library.

VIDEO: The Full Maze Open-Heart Surgery

The Maze procedure open-heart surgery (full Maze) is typically performed in conjunction with surgery to correct another heart condition such as valve disease or coronary disease but can also be performed as a stand-alone treatment.

Cardiac surgeon Edward Soltesz, MD, discusses who is a good candidate for the surgical-based treatment of atrial fibrillation. (Note: He also segues into discussing the Mini-Maze procedure without identifying it by name.) Animation, illustrations and surgical footage. (3:19) Produced and posted by the Cleveland Clinic.

YouTube video playback controls: When watching this video, you have several playback options. The following controls are located in the lower right portion of the frame: Turn on closed captions, Settings (speed/quality), Watch on YouTube website, and Enlarge video to full frame. Click an icon to select.

If you find any errors on this page, email us. Y Last updated: Thursday, March 14, 2019

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My Top 5 Picks: Advanced-Level Atrial Fibrillation Videos

The A-Fib.com Video Library is for those readers who learn visually through motion graphics, audio, personal interviews and animations.

These are my top 5 picks of advanced-level videos. For the reader wanting a more in-depth look inside the EP lab and surgery, and at advanced topics relating to atrial fibrillation.

1. Step-by-Step: Cardioversion Demonstration by ER Staff

Step-by-Step: Cardioversion Demonstration by Alfred Sacchetti

Step-by-Step: Cardioversion

The goal of electrocardioversion is to convert the patient’s rhythm from atrial fibrillation back to normal sinus rhythm.

In this video, emergency room medical personnel demonstrate the equipment, pads placement and procedures of cardioversion. The video describes where pads are properly placed on the patient; how medication is chosen to produce deep sedation; and how after the shock is delivered, a successful cardioversion is confirmed by viewing a normal sinus rhythm on the cardiac monitor.

Close-up of the equipment is shown along with the monitor display. (2:10 min.) Uploaded by Alfred Sacchetti. Go to video->

2. Your Heart’s Ejection Fraction (EF): What You Need to Know

Ejection Fraction with Dr Robert Fishel

Ejection Fraction with Dr Robert Fishel

In the following three short videos, cardiac electrophysiologist, Dr. Robert Fishel, discusses the ejection fraction (EF) a measurement of the pumping efficiency of the heart and why cardiac patients should know their EF percentage.

Video 1: What is the ejection fraction? (:54 sec.) Cardiac Ejection Fraction (EF) is the percentage of blood pumped from the heart’s main chamber during each heartbeat, and why it’s important.

Video 2: Who should know their ejection fraction (EF)? (:34 sec.) Measurement of your Ejection Fraction (EF) is an important test and why A-Fib patients need to know their EF number.

Video 3: How is an ejection fraction measured? (:56 sec.) Ejection Fraction (EF) can be measured by various techniques including an echocardiogram.

Videos hosted by Share.com. Go to videos-> 

3. Mini-Maze Surgery In-Depth: Inside the O.R. with Dr. William Harris, Cardiovascular Surgeon 

Video still of Mini-Maze Surgery at A-Fib.com

In-Depth: Mini-Maze Surgery

Cardiovascular Surgeon, Dr. William Harris describes the Mini-Maze surgery for Atrial Fibrillation. In the Mini-Maze the heart is accessed through small incisions in the chest.

Of interest to A-Fib patients who can not tolerate blood thinners and thus do not qualify for a Catheter Ablation. The Mini-maze surgery is a highly effective with an 85%–95% success rate. (4:49 min.) Dr. Harris is with Baptist Medical Center, Jackson, Miss. Go to video->

4. Pulmonary Vein Isolation In-Depth: Step-by-Step Inside the EP Lab Using Mapping & CT Scan

PVI Step-by-Step Inside the EP Lab video at A-Fib.com

Pulmonary Vein Isolation Step-by-Step Inside the EP Lab

Cardiac Electrophysiologist Dr. James Ong begins with a brief tour of the EP lab and control room; Dr. Ong explains how pulmonary vein isolation is done with radiofrequency ablation to cure atrial fibrillation.

Included are: Mapping technology; the Virtual Geometrical shell of the heart displayed next to the CT scan; Placement of the catheter, real time tracking; the Complex Fractionated Electrogram (CFE) Map used to identify and eliminate the extra drivers (aside from the pulmonary veins). (6:01 min.) From a series of videos by Dr. Ong, Heart Rhythm Specialists of Southern California. Go to video->

5. Long-Standing Persistent A-Fib: A Live Case of Catheter Ablation Through 3D Mapping & ECG Images

Long-Standing Persistent A-Fib: Catheter Ablation Through 3D Mapping & ECG Images Video at A-Fib.com

Long-Standing Persistent A-Fib: Catheter Ablation Through 3D Mapping & ECG Images

Presented entirely through 3D mapping and ECG images, a live demo of ablation for long-standing, persistent A-Fib is followed from start to finish. Titles identify each step (no narration).

3D mapping and ECG images show the technique of transseptal access, 3D mapping, PV isolation, and ablating additional drivers of A-Fib. (8:03 min.) With Dr. James Ong, Heart Rhythm Specialist of Southern California. Go to video->

Note: These videos may require basic understanding of cardiac anatomy and A-Fib physiology.

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In-Depth: Mini-Maze Surgery: Inside the O.R. with Dr. William Harris, Cardiovascular Surgeon

Cardiovascular Surgeon, Dr. William Harris describes the Mini-Maze surgery for Atrial Fibrillation. In the Mini-Maze the heart is accessed through small incisions in the chest.

Of interest to A-Fib patients who can not tolerate blood thinners and thus do not qualify for a Catheter Ablation. The Mini-maze surgery is a highly effective with an 85%–95% success rate. Dr. Harris is with Baptist Medical Center, Jackson, Miss. (4:49 min.)

YouTube video playback controls: When watching this video, you have several playback options. The following controls are located in the lower right portion of the frame: Turn on closed captions, Settings (speed/quality), Watch on YouTube website, and Enlarge video to full frame. Click an icon to select.

If you find any errors on this page, email us. Y Last updated: Friday, September 15, 2017

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