Cardiac surgery has been an independent medical specialty since 1993. It has developed from general surgery, focusing on thoracic and cardiovascular surgery. It deals with the surgical treatment of congenital and acquired diseases and injuries of the heart and the vessels near the heart.
Cardiac arrhythmias require different measures depending on the type of disorder. In some instances, surgical intervention is necessary:
Atrial fibrillation: Atrial fibrillation is primarily treated with medication or with the help of an interventional catheter technique. An alternative, especially for patients who require additional cardiac surgery, is surgical ablation. Ablation creates scar tissue and thus impedes or completely blocks the faulty excitation. The sinus node takes over the control of the heart excitation again.
Sick sinus node (heart pulse generator): This impaired function of the sinus node is often caused by an unspecific scarred degeneration in the conduction system. Measure: Inserting a pacemaker
Transition disorders (AV node): The stimulus conduction between the atrium and chamber is delayed and/or partially/permanently blocked. Measure: Inserting a pacemaker
Rhythm disturbances in the heart chamber (ventricular tachycardia/ventricular fibrillation): Life-threatening, as the heart, can no longer maintain circulation. Measure: Insertion of a defibrillator or ICD (Internal Cardioverter/Defibrillator). The defibrillator (shock generator) can independently interrupt electrically circulating excitation in the heart, utilizing targeted current pulses. At the same time, the device also has all the functions of a standard pacemaker.
Unfavorable contraction of the heart in patients with severe heart failure and left bundle branch block (insufficient pumping capacity of the heart) Measure: Use of a CRT system. A CRT system is a normal pacemaker with three electrodes; one in the atrium, one in the right, and one in the left ventricle. This allows the heart to be stimulated synchronously again. The unfavorable effects of the left bundle branch block are bridged. Some devices also contain a defibrillator function.