SINGAPORE — Atrial fibrillation (AF) is the most common heart rhythm disorder in the world. Worryingly, its prevalence also increases with age. According to a global study in 2019, this hidden killer affects a staggering 59.7 million people worldwide.1 In the last two years, over 80 per cent of the patients seen for heart rhythm disorders at the National University Heart Centre, Singapore (NUHCS) suffer from AF. If left untreated, patients face higher risks of stroke, heart failure and death.
Treatment depends on each individual, and may involve medication or interventions to reset the heart rhythm. One type of intervention is known as cardiac ablation, a method of intentionally creating precise areas of scarring to block or interrupt abnormal electrical signals within the heart. This can be done surgically or non-surgically, usually using heat (radiofrequency ablation) or cold (cryoablation) energy. Surgical ablation is commonly done when the patient requires open heart surgery for a related heart valve condition. This combination surgery would typically have to be done via a fully open chest surgery.
In July 2024, NUHCS performed Singapore’s first minimally invasive complete cryoablation surgery for AF, reducing surgical risks, complications, and offering a shorter length of stay in the hospital as well as faster recovery for eligible patients. Since then, six more patients have undergone this procedure, known as minimally invasive CryoMaze.
“Traditionally, CryoMaze has been done via a fully open chest surgery and was the only way to achieve a complete ablation in patients who require heart valve surgery. This ablation procedure has a documented success rate of over 70 per cent in preventing AF recurrence,” shared Dr Chang Guohao, Consultant, Division of Adult Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Surgery (CTVS), NUHCS, who performs the keyhole cryoablation surgeries at NUHCS.
Patients with AF usually suffer from associated heart valve conditions affecting the mitral and/or tricuspid valve, and these conditions would be treated together in the same surgery. Patients who previously had to undergo a fully open chest surgery now have the option of keyhole surgery to achieve surgical AF CryoMaze while receiving heart valve surgery in the same sitting.
“With the minimally invasive CryoMaze option now available at NUHCS, not only is the AF treatment safer and less traumatic for eligible patients requiring surgical ablation, but their recovery time is also reduced by about half,” said Dr Chang.
This minimally invasive alternative not only shortens recovery time and enhances clinical outcomes and patient experience, but also underscores NUHCS’s commitment to delivering the best cardiovascular services to meet evolving healthcare needs.
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1 Li H, Song X, Liang Y, Bai X, Liu-Huo W-S, Chao T et al. Global, regional, and national burden of disease study of atrial fibrillation/flutter, 1990–2019: results from a Global Burden of Disease Study, 2019. BMC Public Health 2022;22:2015.
