Rhythm surgery

The Maritime Heart Center has been a leader in performing anti-arrhythmia surgery. Specifically for the treatment of atrial fibrillation or flutter, a modified Cox-Maze procedure has been offered to patients with this problem using cryo-ablation or radio-frequency ablation. We are currently in the process of becoming involved in a multi-centre clinical trial using a high-frequency ultrasonic ablation device.

Pacing and Defibrillator Devices

At the present time Cardiac surgeons with the Maritime Heart Center are actively involved in three areas of electrophysiology:

1. The first area is the implantation of cardiac pacemakers. This is a traditional area of involvement and involves both single and dual chamber implantations. There is a steady stream of patients requiring pacemakers that has not changed a great deal over the years and remains the bulk of the electrophysiology work. Implantation techniques have not changed a great deal but the complexities of the units implanted have increased. Follow up has generally been with cardiology unless there is some surgical complication.
2. The secondary area of involvement, involves the implantation of defibrillation devices. The indications for implantation of an AICD have broadened and the technology has improved so that many more of these devices are being implanted currently as compared to the past. Programming and follow-up has principally been in the realm of the cardiologists, as the cardiac surgeons remain actively involved with them in the operating room with the initial programming and testing of these complex units. The third area of involvement is in the implantation of resynchronization devices. These very specialized pacemaker units are placed in patients with very poor cardiac function and this is an area of active research as well as broadening indications. The implantation of these units requires a collaborative effort between the surgeons and the cardiologists and has a wide range of complexity. This field shows every indication of becoming much broader and more complex with time and occupying a much larger proportion of our time.
3. A final field in which we are not actively involved in yet but which we would like to become involved in the future involves the removal of old pacing leads. This area requires fairly expensive technology which we are in the process of trying to acquire. Certainly with the growing use of pacing, defibrillation, and resynchronization leads there is going to be an increasing requirement for removal of these leads in a variety of circumstances and we will be requiring the technology necessary to remove these leads a necessary.