Unique, minimally invasive robotic MAZE surgery normalizes heart rate for AFib patient
February 28, 2022
But back in 2017, Reber felt rotten. He was tired all the time. Small actions, like walking up a few stairs or taking a shower, gave him heart palpitations and left him winded.
“I’m strong as an ox, normally, but I felt like I was going to die,” the 57-year-old said.
Reber went to the doctor, where his heart rate was 240 – almost triple the normal rate. His physician feared Reber was having a massive stroke and sent him straight to the emergency room. Reber didn’t have a stroke but was diagnosed with atrial fibrillation, or AFib.
AFib is a common heart arrhythmia that causes the heart to beat irregularly, usually too quickly but sometimes too slowly. The diagnosis posed a huge problem for Reber, a licensed pilot who needs to pass a flight physical each year. If his AFib was not well-controlled, his pilot’s license would be revoked.
For the next few years, Reber treated his AFib with blood thinners, antiarrhythmic medications and two heart ablation procedures to normalize his heart rate.
Ablations are often successful treatments for patients with AFib. The procedure involves inserting a catheter into the heart to create small scars in the heart’s upper chamber, disrupting the signals that cause the heart to beat erratically.
However, Reber’s first ablation, in 2017, worked for only a week. The second, in 2018, restored his heart rhythm to normal for a few weeks. With seemingly no other options, Reber scheduled a third ablation.
“I said to the doctor, ‘Look, what are you gonna do different this time? Because this isn’t working and my insurance company is about done paying for this,’” he said.
Reber’s friend suggested he talk to an electrophysiologist he knew in Missouri. That doctor told Reber about cardiac surgeon Husam H. Balkhy, MD at the University of Chicago Medicine. He’d been referring his difficult AFib patients to Balkhy for years, since UChicago Medicine is one of the few places in the world that performs a robotic minimally invasive surgical ablation known as the MAZE procedure to correct heart arrhythmias in AFib patients without other cardiac problems.
The robotic MAZE surgery has a much higher success rate than a catheter ablation procedure, especially in patients with persistent and long-standing AFib, Balkhy said. However, most hospitals only offer MAZE as part of open-heart surgery when other procedures are being done.
“To perform open-heart surgery just to treat AFib is unique. Not many cardiac programs will do that,” Balkhy said.
In the three-hour robotic MAZE surgery, Balkhy and his team use an energy probe or scalpel to draw precise lines on the heart’s upper chamber. This is a more effective way to control the arrhythmia because it creates thick scarring that disrupts the abnormal signals being sent to the heart and that produces the AFib rhythm.
Balkhy works through incisions no longer than a half-inch, assisted by the da Vinci robot which magnifies the area 10- to 12-times its actual size. Since the surgery is minimally invasive, recovery time is significantly less than for traditional open-heart surgery.
“Usually after a week or two, the only thing they have is a little soreness,” Balkhy said.
Reber flew to Chicago from his home in St. George, Utah, and had the robotic MAZE surgery in June 2021. It went smoothly and he’s been symptom-free ever since.
“I’ve never been treated as well as I was in Chicago,” Reber said. “It was a little intimidating to be in this big hospital all by myself, but it was amazing to me that someone from a small country town of 50,000 people could come to a big city like this and get this kind of care.”
Reber said he was impressed that Balkhy – a pioneer in the field of minimally invasive and robotic cardiac surgery – took the time to meet with him. Knowing he was coming from out of town, Balkhy’s staff scheduled all of Reber’s tests to be as time-efficient as possible.
“I was out of the hospital within two days, and back home in Utah five or six days later. I went back to work about two weeks later,” Reber said. “As far as my heart goes, I feel as healthy as a horse now. I don’t get tired. I have a lot more endurance. I’ve had no issues with my pilot’s license. There’s still a little scarring from the surgery incisions, but I feel better every day.”
Balkhy said the robotic MAZE procedure is an option for patients whose AFib has not responded to other treatments such as medication and catheter ablation.
“Depending on their history and the type of AFib they have, about 90% of patients won’t have AFib anymore after a MAZE procedure,” Balkhy said.
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