Atrial fibrillation is a widespread cardiac rhythm disorder in which the upper chambers of the heart do not beat effectively because of abnormal electrical activity. AF results in reduced cardiac output, exacerbates heart failure and can lead to stroke or other neurological problems. AF affects more than six million people worldwide.
"Ultrasound technology dramatically simplifies the Maze procedure, eliminates the need to stop the heart from beating and soon will allow us to perform the Maze procedure minimally invasively and routinely as a stand-alone surgery," says Patrick McCarthy, M.D., co-director of the Northwestern Cardiovascular Institute and chief of cardiothoracic surgery at Northwestern Memorial Hospital, who performed the country's surgical first and is one of the few surgeons trained to use the High Intensity Focused Ultrasound (HIFU) surgical ablation technology manufactured by St. Jude Medical, Inc.
"Northwestern Memorial Hospital is an outstanding partner to debut our HIFU technology to the United States," said Jane J. Song, President of St. Jude Medical's Atrial Fibrillation business. "Dr. McCarthy's renowned international reputation and vast experience in the surgical treatment of atrial fibrillation, combined with Northwestern Memorial's commitment to building a premier heart program, make them the ideal team to introduce this new approach to surgical cardiac ablation." The Maze procedure is the most effective cure for AF, eliminating irregular heartbeats – a primary reason for stroke, heart attacks and heart failure – in 97 percent of patients. While considered the gold standard in surgical treatment of AF, the Maze procedure is only performed by a handful of surgeons across the country because it is so technically challenging. In addition, because it requires patients to go on a heart-lung machine for up to an hour, it has typically been reserved for patients requiring other cardiac surgical procedures, such as coronary artery bypass graft or valve repair.
"While the Maze procedure is routine and incredibly safe when done by those surgeons who are experienced with the technique, many physicians still think of it as a failure if a patient with AF does not respond to medical therapy and has to be referred for surgery," says Dr. McCarthy. "The perceived magnitude of this surgery and the possibility of some complications associated with the heart-lung machine are responsible for this trend. The ultrasound technology enables us to perform a 'simplified Maze' that is highly reproducible. This innovation is likely to lead to more surgeons who can do the procedure and more patient referrals as physicians begin to consider the Maze a much simpler and safer surgery that doesn't require heart-lung bypass. I think we'll also begin seeing earlier referrals rather than this being the treatment of last resort."
In the Maze procedure, maze-like patterns are strategically made in the left upper chamber of the heart to interrupt the electrical signals causing the irregular heartbeat. Scar tissue, which does not conduct electrical activity, forms and prevents erratic electrical signals from recurring. The HIFU technology allows surgeons to recreate these patterns by placing a device that delivers high-intensity focused ultrasound to the outside of the heart in a precise pattern. When combined with another cardiac procedure, the 'simplified Maze' using the HIFU system adds less than five minutes to the overall procedure time.
"I anticipate that soon I'll begin doing the 'simplified Maze' procedure with the HIFU technology minimally invasively with only about an 8 cm incision and sending patients home after a day or two instead of after five days as is currently typical in patients who've had a Maze procedure," says Dr. McCarthy.
The NCVI includes a core infrastructure of six centers: The Center for Heart Valve Disease, The Center for Heart Failure, The Center for Atrial Fibrillation, The Center for Coronary Disease, the Center for Vascular Disease and the Center for Women's Health. "Launching the HIFU technology in the U.S. is the beginning of what we expect to be many national firsts at Northwestern's recently established Center for Atrial Fibrillation. We are intensely focused on researching the genetics that predispose patients to develop AF and are now ready to launch piloting minimally invasive surgical technology for AF."
About Northwestern Memorial Hospital
Northwestern Memorial Hospital (NMH) is one of the country's premier academic medical centers and is the primary teaching hospital of Northwestern University's Feinberg School of Medicine. Northwestern Memorial and its Prentice Women's Hospital and Stone Institute of Psychiatry have 744 beds and more than 1,200 affiliated physicians and 5,000 employees. Providing state-of-the-art care, NMH is recognized for its outstanding clinical and surgical advancements in such areas as cardiothoracic and vascular care, gastroenterology, neurology and neurosurgery, oncology, organ and bone marrow transplantation, and women's health.
Northwestern Memorial was ranked as the nation's 5th best hospital by the 2002 Consumer Checkbook survey of the nation's physicians and is listed in eight specialties in this year's US News & World Report's issue of "America's Best Hospitals." NMH is also cited as one of the "100 Best Companies for Working Mothers" by Working Mother magazine and has been chosen by Chicagoans year after year as their "most preferred hospital" in National Research Corporation's annual survey.
About the Northwestern Cardiovascular Institute
The NCVI is a world-class heart program offering comprehensive services and state-of-the-art surgical treatments in all areas of cardiovascular care. Patients treated at Northwestern Memorial Hospital benefit from a timely response to referrals and a multidisciplinary approach that joins physicians, nurses and a range of other medical specialists and caregivers from Cardiology, Cardiac Surgery, Vascular Surgery, Cardiovascular Anesthesiology and Radiology from evaluation to follow-up. Patients benefit from the latest minimally invasive surgical techniques and are offered the opportunity to participate in a range of clinical research trials.
Advanced Cardiovascular Care
Patients referred to the Northwestern Cardiovascular Institute experience a healthcare environment in which the most advanced diagnostic and treatment options are supported by state-of-the-art technology and a commitment to medical excellence through research. Expertise is available in all areas of cardiovascular care, including:
Cardiac Surgery
- Valve repair and replacement
- MAZE and atrial fibrillation ablation procedures
- Coronary artery bypass with arterial conduits
- LV and aortic aneurysm repair
- Congestive heart failure surgery
- Ventricular assist devices
Vascular Surgery
- Thoracic and abdominal aortic aneurysm surgery
- Carotid endarterectomy and stents
- Endovascular surgery for aortic aneurysms and limb salvage
- Lower extremity bypass procedures
- Uncommon mesenteric and upper extremity revascularization
- Supraaortic trunk revascularization
Cardiology
- Primary and secondary prevention
- Advanced diagnostic testing including echocardiography, nuclear cardiology, cardiac MRI and computed tomography
- Cardiac electrophysiology, including diagnostic EP procedures, catheter ablation and pacemaker and ICD implantation
- Heart failure management
- Evaluation of heart valve disease
- Acute coronary care
- Diagnostic catheterization and interventional cardiology