Doctor Develops Procedure to Help Regulate Heartbeats

Four million people have atrial fibrillation, the most common heart rhythm disorder. Out of 700,000 strokes in the United States every year, 140,000 can be linked to atrial fibrillation. It's most common in the elderly or those with different heart defects.

Posted 10:21 p.m. Jun 20, 2007 — Updated 7:30 p.m. Jun 21, 2007

PINEHURST — Four million people have atrial fibrillation, the most common heart rhythm disorder.

Out of 700,000 strokes in the United States every year, 140,000 can be linked to atrial fibrillation. It's most common in the elderly or those with different heart defects.

Electrical impulses are what cause the heart to beat and pump blood. For some people, that system can go haywire and cause the heart's atrial chambers to fibrillate or beat irregularly. That's called atrial fibrillation.

More blood pools up in the upper chambers, which increases the risk of clots and, therefore, stroke. The options have been medical management, shock therapy to bring the heart back into rhythm, ablation therapy or surgical treatment.

A new procedure developed at FirstHealth Moore Regional Hospital called the Ex Maze procedure is a less invasive way to get the heart permanently back in rhythm.

The standard surgery, called the Cox Maze procedure, involves stopping the heart, cutting it into sections and sewing it back together. The scars redirect the electrical currents to restore normal rhythm.

Dr. Andy C. Kiser, chief of thoracic surgery at FirstHealth Moore Regional and a cardiologist, developed a new procedure called Ex Maze to accomplish the same thing as Cox Maze, but less invasively.

Using a plastic surgical model, Kiser demonstrated how his procedure uses a special heating coil encased in a long tube.

"We pass the device behind the heart, and the tether pulls right behind the heart and you can see how easily that goes through," he said.

Suction attaches the short heating coil to the surface of the heart to create a scar. The multiple scars form a pattern, or maze, all around the surface of the heart to disrupt the irregular electrical impulses.

"You direct the current of the heart in the direction that you want it to go," Kiser said.

There have been 70 such procedures done worldwide; 20 of them at FirstHealth Moore Regional Hospital. It's where many surgeons around the country will come for Ex Maze training.

"There are 3 or 4 million Americans today who don't have a good treatment for atrial fibrillation," Kiser said. "This device has really enabled us to do now what people have been trying to do for years, without having to stop the heart and cut the heart."

Until now, the procedure has only been done in conjunction with other open heart procedures. In about two months, the first "stand alone" Ex Maze procedure will be done at FirstHealth Moore Regional Hospital.

Kiser said the long-term plan is to try to do the procedure laparoscopically through small incisions, but even standard surgery for it poses a much lower risk than the current standard surgery of stopping and cutting into the heart.

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