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Maine Medical Center first in Maine to repair abnormal heart rhythm.

New Minimally Invasive Surgery Eliminates Irregular Heartbeats and Significantly Reduces Risk of Stroke and other Heart Disease

(PORTLAND) – More than three million people across the United States have been diagnosed with atrial fibrillation – a serious form of an irregular heartbeat that can cause rapid heartbeat and stroke. Approximately 300,000 new cases of atrial fibrillation are diagnosed each year. A new procedure now available at Maine Medical Center may permanently eliminate atrial fibrillation. The procedure, called a “mini-maze” has only been done three times in New England – once in Boston, once in Rhode Island, and once in Maine, at Maine Medical Center.

Atrial fibrillation, or afib, can carry serious consequences. It increases the risk of stroke tenfold, and may be associated with the development of congestive heart failure as well as more serious, life-threatening irregular heartbeats. Daily living with atrial fibrillation is not easy. Many patients with atrial fibrillation are very symptomatic, may require medications with significant side effects, lose time at work or need to be hospitalized.

“This procedure has the potential to permanently eliminate afib,” said Scott Buchanan, M.D., a heart surgeon at Maine Medical Center and partner with Maine Heart Surgical Associates in Portland. “Atrial fibrillation is a very common disease that affects a significant number of people in our community. Although many patients with atrial fibrillation are well managed on standard medical therapy, a large number have debilitating symptoms such as palpitations, breathing trouble, weakness, and side effects from medications,” says Dr. Buchanan. “I’m excited that they now have an option to relieve their discomfort.”

Atrial fibrillation is an irregular heart rhythm that interferes with the heart’s ability to pump blood. Abnormal electrical signals begin at the top of the heart and travel down the muscle, causing the atria, or upper chambers, to contract erratically. As a result, the blood can pool in the atria and form clots that can travel to the brain and cause stroke. Afib is thought to be responsible for 15% of the strokes in the United States each year.

In the mini-maze procedure, surgeons destroy a small amount of tissue using radio-frequency energy in the area near where the irregular signal starts. The damaged tissue can no longer conduct electrical impulses, interrupting the transmission of the abnormal signal and allowing the rest of the chamber to resume beating normally. Mini-maze surgery may permanently eliminate atrial fibrillation in more than 85% of patients who undergo the procedure.

“By isolating the zone where the irregular heartbeat originates, we keep the rest of heart from being affected,” Dr. Buchanan explains. “We’ve known for some time that this can be an effective strategy for treating atrial fibrillation, but until now we haven’t had the tools to do it easily.”

The mini-maze technique is being used in two ways. For patients who suffer from atrial fibrillation alone, the procedure is done in a minimally-invasive way. In this approach, doctors perform the entire operation through a small incision between the ribs with the assistance of a fiber-optic camera. For patients who require surgery for other types of heart conditions, for example, heart valve replacement or coronary bypass, the atrial fibrillation treatment can be easily performed during these common heart operations.

Atrial fibrillation is now most often treated with anticoagulant drugs, which help prevent blood clots from forming, medications to control heart rate, and/or medications to prevent the atrial fibrillation itself. Other treatments, including catheter-based procedures and older forms of surgery, are available to correct the abnormal rhythm of atrial fibrillation and may be appropriate for some patients. “A great deal of research is being done in this area to determine the best ways to treat patients with atrial fibrillation,” says Joel Cutler, M.D., Director of Electrophysiology at Maine Medical Center. “The mini-maze procedure represents an important tool in our armamentarium. It is very exciting that it is now being done here.”

Carol Honaberger of Bridgton was the first patient in Maine to have the mini-maze procedure. She was diagnosed with atrial fibrillation in March 2003. Despite trying a number of different medicines to treat the problem, her symptoms persisted. “I would get severely dizzy and my heart would start beating so hard…I was almost sure that when I looked down at my chest I would see it pounding through my shirt,” she says. “It’s the type of beating that would resonate throughout my entire body. And it would come on without much warning – in the grocery store or during dinner with friends. It was extremely disconcerting.”

Honaberger would spend at least one day a week in afib, each episode lasting up to 16 hours. She’d then need a day to recover from the physical and mental strain. When her cardiologist referred her to Dr. Buchanan as a potential candidate for the mini-maze surgery, she was elated.

“Some of my friends were worried that I was going to be the first patient in Maine to have the mini-maze procedure. But I had so much faith in my doctors, I knew I was in good hands,” says Honaberger, who had the minimally-invasive surgery with Dr. Buchanan in October 2005. “And now that the afib is gone, I feel wonderful. I have so much more energy and am not constantly worried about going into afib.”

“It is gratifying to see how well Mrs. Honaberger is doing.” Dr. Buchanan added. “We hope to offer this mini-maze procedure to others in the near future.”

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