Most complications from concomitant Cox maze IV surgical ablation procedures are related to the primary open-heart surgery, such as valve replacement or coronary artery bypass grafting (CABG), not the ablation procedure for atrial fibrillation.
The Society of Thoracic Surgeons (STS), a professional organization of heart and lung surgeons, collects outcomes of 85% of all heart surgeries performed in the US. Researchers can access the database to identify patterns in treatment and track complications. For example, one report compared the outcomes of mitral valve procedures with and without ablation for patients with atrial fibrillation. Except for more afib patients requiring a permanent pacemaker, the complication rates were similar between the two groups.1 Other complications included fluid retention and cardiac arrhythmia the first few weeks after surgery. Those usually subsided as the heart and body healed.
If patients have had afib for many years, the sinus (sinoatrial) node, the heart’s natural pacemaker, may no longer work properly and a permanent pacemaker is required. Unfortunately, this often isn’t discovered until the patient’s afib has been corrected. Sometimes, the sinus node is damaged during the afib ablation, and the patient needs a permanent pacemaker after a concomitant procedure.
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In the Society of Thoracic Surgeons report, patients who received afib surgical ablation had fewer strokes than those who did not. That is likely due to the heart’s left atrial appendage being addressed during concomitant ablation procedures.1 The left atrial appendage is often closed during open-chest procedures to lower the patient’s stroke risk.
If you’re considering having surgery for your afib, see Are You a Candidate for a Maze Procedure.
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