Atrial Fibrillation The most common heart rhythm disorder, atrial fibrillation affects an estimated five million Americans. Atrial fibrillation (AF) is the rapid, erratic beating of the atria, the two upper chambers of the heart. The atria quiver instead of beating rhythmically, because the electrical impulses that cause them to contract don’t follow the normal pathways. Instead, they travel through the heart in chaotic fashion. The atria pump blood to the lower chambers of the heart, the ventricles. When the atria don’t beat normally, blood collects in the atria and moves through the heart sluggishly and intermittently. This increases the risk of blood clots, which can cause strokes. About 15 percent of strokes are the result of AF, which also can cause heart failure. Causes of Atrial Fibrillation Symptoms of Atrial Fibrillation Categories of Atrial Fibrillation
Current Treatment Options Various methods have been developed to block stray electrical impulses and to guide electricity onto the correct pathways through the heart. Maze-like patterns of scar tissue, which is a barrier to electrical conduction, are created by cutting or, more often, cauterizing the heart muscles.
Ex-Maze Treatment for Atrial Fibrillation The Ex-Maze Procedure To date, in the United States, the procedure has been performed only on patients whose chests had been opened for some other heart procedure such as a coronary artery bypass or valve repair. However, Dr. Kiser expects to make the procedure available soon to patients who have severe atrial fibrillation but no other heart problems. While in Europe earlier this month, Dr. Kiser performed the world’s first Ex-Maze procedure without opening the patient’s chest. The minimally invasive procedure, which took place in Krakow, Poland, required just four small laparoscopic incisions and took about two hours to perform. The Ex-Maze Device The Ex-Maze device is different in that it has a vacuum system that keeps it in direct contact with the heart. This helps ensure that the pattern of scar tissue is consistent and unbroken, so stray electrical impulses can’t travel far enough to cause a problem. A saline solution flows continuously through the plastic tube that contains the Ex-Maze device’s heating coil. This prevents the surface of the heart from being burned while the deeper muscle is cauterized. The Ex-Maze device was developed by nContact Surgical Inc. of Morrisville, N.C. (http://www.ncontact.us/) Advantages of the Ex-Maze The Ex-Maze procedure creates a pattern of scar tissue that completely encircles the heart and blocks all errant electrical impulses. Because the Ex-Maze procedure is performed on a beating heart, the surgeon can see the change from atrial fibrillation to normal heart rhythm and know that the procedure has been successful. The procedure can be used to treat both “persistent” AF and “permanent” AF, for which there is no other reliably effective treatment. For more information please go to www.ex-maze.com
A native of Moore County, N.C., Dr. Kiser pioneered the development of the Ex-Maze procedure and has refined it in collaboration with cardiothoracic surgeons in Poland and Germany, where the procedure is now the standard of care for AF in several medical centers. Dr. Kiser is:
Degrees: 1992 Medical Doctor with Honors, University of North Carolina School of Medicine Postgraduate Training: Board Certifications: Professional Memberships: For additional information on Dr. Kiser, call (800) 213-3284.
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