Treatment Options

• Maze Surgery for Atrial Fibrillation
• Minimally Invasive Maze Surgery
  • How the Procedure is Performed
  • An Alternative to Coumadin
  • Comparing Mini-Maze to Catheter Ablation
  • Who is a Candidate?
  • Preparing for Your Surgery
  • Recovering from Surgery
• Endovascular Stent
• Valve Repair & Replacement
• Surgery for Hyperhidrosis
• Endovascular Blood Vessel Repair

Catheter Ablation vs. Mini-Maze: Which is the Cure?

Catheter ablation was a medical marvel when it began being used to surgically repair heart damage, heart disease and cardiac arrhythmias in the 1980's. As it turned out, catheter ablation is a successful treatment option for almost every arrhythmia except atrial fibrillation. Catheter ablation has been successfully used to treat Wolff-Parkinson-White (WPW) syndrome, right atrial flutter, and supraventricular tachycardia (SVT). But atrial fibrillation is a much more complex cardiac arrhythmia, and catheter ablation is much less successful as a curative procedure for afib. In some cases, catheter ablation can be detrimental if patients decide to have the Mini-Maze after having catheter ablation.

Many people think that heart surgery requires your ribs to be cracked, your chest to be opened, and your heart to be stopped. But the Mini-Maze is a minimally invasive, closed chest heart surgery that can cure your atrial fibrillation. Dr. Affleck has performed more Mini-Maze surgeries than any other surgeon in the western United States. Whether you live in Salt Lake City, Ogden, or Utah Valley, or anywhere in the country, contact MountainStar Cardiovascular Surgery online or call us at 801-743-4750 today. Understand your options, cure your heart.

Catheter Ablation Procedures

Catheter ablation varies from procedure to procedure, but generally follows the same protocol. Catheters are surgically inserted into a femoral vein in the leg or groin area. The catheters are moved through the circulatory system up into the chambers of the heart. Once the catheters reach the heart, the septal wall (the wall between the two atria of your heart) is punctured and a guide wire is advanced into the left superior vena cava (pulmonary vein). The catheter tip is then advanced into the left atrium using the guide wire and the catheter tip creates a lesion, usually using an energy source to isolate the pulmonary veins. Catheter ablation can also be used in right atrial compartmentalization, left atrial compartmentalization, and to ablate focal triggers in both atria.

The Mini-Maze Surgery

The Mini-Maze is a closed chest, minimally invasive cardiac surgery to cure atrial fibrillation. By using radiofrequency energy, Dr. Affleck is able to surgically ablate the heart tissue to isolate the pulmonary veins and create lesion scars that block irregular electrical impulses from affecting cardiac conduction. The Mini-Maze is available for patients when open heart surgery is unnecessary because there is no structural heart disease.

The Mini-Maze requires three small incisions on both sides of the chest. The heart is accessed through these incisions so the ribs do not have to be cracked. The surgery takes approximately 4 hours. Most of our patients stay in the hospital for approximately 3 days. Find out more about how the Mini-Maze procedure is performed.

Catheter Ablation Success Rates

A study published in the Journal of Interventional Cardiac Electrophysiology in 2006, reported that long term success rates for curing atrial fibrillation with catheter ablation was 28% for single procedure outcomes. This study refuted the success rates of other studies by requiring at least one year of follow up for the study's subjects. ECG monitoring was mandatory at every follow up visit, and in-depth phone interviews were conducted with each patient. Success rates went up to 42% for patients who received a second catheter ablation procedure.

Mini-Maze Success Rates

Dr. David Affleck's Mini-Maze procedure has been shown to cure atrial fibrillation in more than 90% of his surgical patients. For patients with permanent-consistent atrial fibrillation, the success rate is 70%, which is 20% higher than other medical facilities offering similar surgical procedures. Because Dr. Affleck combines radiofrequency and cryothermy, his Mini-Maze procedure is more efficient, effective and curative than other procedures.

Risks of Catheter Ablation

Although catheter ablation is not considered to be major surgery, the procedure carries specific risk. Studies have shown that patients who have catheter ablation actually increase their risk of stroke, transient ischemic attacks and tamponade (an accumulation of fluid in the heart). Researchers believe thrombi occur at the catheter site either during or after ablation because the body's natural platelet and coagulation systems are activated by the procedure.

Mini-Maze Risks

Risks from Mini-Maze surgery are reduced because the procedure is generally short and it is a closed chest procedure. Common risks from this surgery include collapsed lung (which is correctable with a chest tube), vein inflammation, heart tissue inflammation and blood vessel damage.

As with every procedure performed at MountainStar Cardiovascular Surgery, Dr. Affleck will help you understand how your overall health and age affect these risks, his methods for lowering these risks, and what your options are should any of these risks occur.

Dr. Affleck has a cure, you have options. Contact MountainStar Cardiovascular Surgery online or call us at 801-743-4750 today. If you live outside the Salt Lake City, Ogden, Utah Valley, don't let geography determine your treatment. WCA has a successful fly-in program and can help you with after care, accommodations and travel arrangements.