Treatment of atrial fibrillation

Atrial fibrillation is the most commonly occurring cardiac arrhythmia. Atrial fibrillation very often accompanies other heart diseases such as coronary heart disease and/or valvular heart disease. Long-standing atrial fibrillation leads to an enlargement of the cardiac chambers. This enlargement in turn causes an impairment of blood flow within the heart chambers. The consequence is a drop in cardiac performance, which can progress to heart failure. At the same time, with atrial fibrillation there is a risk of blood clot formation within the cardiac chambers (in the left auricle), especially if blood clotting is not continually controlled by medications. These clots can become detached spontaneously, pass into the circulation and block a blood vessel, for instance in the brain, thus causing a stroke.

In order to prevent these consequences of atrial fibrillation, an operation method (COX-MAZE procedure) was developed in the 1990s to eliminate this arrhythmia and restore a normal, regular heart rhythm (sinus rhythm). Over the years, the operation methods and various operating devices have been developed and refined. The operative approach is either through a conventional opening of the breastbone (sternotomy) or through small incisions (minimally invasive). The success rate of this operation is about 80%, i.e., atrial fibrillation can recur in 20% of cases, especially shortly after cardiac surgery.