Solving the Puzzle

Minimaze surgery helps correct heart disturbance.

When your heart works well, you likely give it little thought beyond the exercise and healthy foods you send its way to keep it in shape. You may not even be aware that your heart generates electrical signals to keep its rhythm on target. But people who suffer from atrial fibrillation (AF) are very aware of the role electricity plays in their hearts' health.

"Normally, all of the muscle cells in the heart's upper chambers contract together, then relax. Then those in the lower chamber contract together and relax," explains James Edgerton, M.D. a cardiothoracic surgeon on the medical staff at Baylor Regional Medical Center at Plano. "But sometimes the electricity in the upper chambers starts firing chaotically."

When this erratic signaling strikes, the cells contract randomly, leading to fibrillation. "Patients get a very rapid heart rate, and a constant barrage of electricity is sent to the lower chambers," he explains.

It's more than just disconcerting. People with AF may feel very weak because their blood is not circulating efficiently, and they run the risk of a stroke because clots in their hearts can prevent the blood from flowing properly.

"What we do to treat people with AF is channel the electricity so it cannot keep passing around in chaotic circuits," Dr. Edgerton explains. Electricity cannot cross scars, so surgeons create scars in the heart's upper chambers that channel the electricity properly. The term "minimaze" refers to the minimally invasive techniques surgeons use to operate (the "mini") and the complex paths that channel the electricity from the start point to the end point (the "maze").

Today, surgeons can perform the operation while the heart is beating, without opening the chest. The procedure typically takes about three hours, followed by a three- to fourday recovery in the hospital. "Most people feel pretty good six to eight days after surgery, and if they have desk jobs they're back to work in 10 to 14 days," Dr. Edgerton says. Because AF episodes can be debilitating, people who have the operation are grateful for the results. "Of all the operations I do, these are the most thankful patients. Many have been disabled for years and they're back on their feet without these crippling episodes. They just feel so much better," he says.

By Stephanie Thurrott

For more information about the minimaze procedure and other cardiac services at Baylor Plano, call 1-800-4BAYLOR.