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Surgical Procedures for Arrhythmias (Heart Rhythm Disturbances)

Surgery can be used to:

  • Remove tissue to disrupt factors that cause arrhythmias
  • Implant devices that trigger and maintain regular rhythm

Tissue Removal

Radiofrequency Catheter Ablation

During radiofrequency catheter ablation , abnormal electrical circuits in the heart that generate harmful rhythms can be located and destroyed. A catheter is introduced through a vein and advanced until it reaches your heart. Then, electrodes are heated with a radiofrequency energy that subsequently destroys areas of the heart tissue that cause the arrhythmia. This procedure is most frequently used to treat atrial flutter , atrial fibrillation , or ventricular tachycardia .

Maze and Mini-Maze Procedures

The Maze procedure is a technique used to surgically treat atrial fibrillation (AF) that involves making several small incisions within the wall of the atria. This results in the formation of scar tissue that blocks the electrical impulses that cause the arrhythmia.

The Maze procedure may also be done as minimally invasive surgery, called mini-Maze . It only requires one or two small incisions in the chest.

Subendocardial Resection

In certain cases of a ventricular tachycardia, specific abnormalities within the heart muscle might be responsible for generating the arrhythmia. The removal of the scar tissue underneath the lining of the heart may prevent the arrhythmia from occurring.

Implanted Devices

Pacemaker

If the sinoatrial node malfunctions or stops working, an artificial pacemaker can be implanted to generate regular impulses. Pacemakers are implanted during a minor procedure. A wire is attached to your heart either through a blood vessel or directly into the chest. The wire is also attached to the device. An incision is made, and the device is placed under your skin, usually near the collarbone.

Pacemaker
IMAGE
Copyright © Nucleus Medical Media, Inc.
Cardioverter Defibrillator

An implantable cardioverter defibrillator (ICD) is a device that can help change dangerous arrhythmias to healthy ones. It can also stimulate a heart that has had a sudden cardiac arrest. The implant sits just under the skin in the chest and wires are passed through a blood vessel to the heart. An ICD is used for people with serious ventricular heart arrhythmias. These arrhythmias are very likely to lead to cardiac arrest and death. The ICD can send signals to:

  • Reset certain arrhythmias to normal rhythm
  • Stimulate the heart to beat at a regular rate
  • Restart a heart that has stopped beating
Implantable Cardioverter Defibrillator
IMAGE
Copyright © Nucleus Medical Media, Inc.

Pacemakers and ICDs have power sources that last a long time. Nevertheless, they should be checked occasionally to make sure they are still working. Your cardiologist will give you instructions on the care and maintenance of your device.

Pacemakers and ICDs have power sources that last a long time. Nevertheless, they should be checked occasionally to make sure they are still working. Your cardiologist will give you instructions on the care and maintenance of your device.

Revision Information

  • Colucci R, Silver M, Shubrook J. Common types of supraventricular tachycardia: Diagnosis and management. Am Fam Physician. 2010;82(8):942-952.

  • Horowitz LN, Harken AH, Kastor JA, Josephson ME. Ventricular resection guided by epicardial and endocardial mapping for treatment of recurrent ventricular tachycardia. N Engl J Med. 1980;302(11):589-593.

  • How are arrhythmias treated? National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health/health-topics/topics/arr/treatment. Updated July 1, 2011. Accessed March 20, 2014.

  • Pacemakers. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T906162/Pacemakers. Updated April 20, 2017. Accessed June 1, 2017.