{"id":1615,"date":"2021-10-14T17:02:27","date_gmt":"2021-10-14T17:02:27","guid":{"rendered":"https:\/\/www.heart-valve-surgery.com\/learning\/?page_id=1615"},"modified":"2025-06-03T20:44:08","modified_gmt":"2025-06-03T20:44:08","slug":"atrial-fibrillation-cox-maze-iv","status":"publish","type":"page","link":"https:\/\/www.heart-valve-surgery.com\/learning\/atrial-fibrillation-cox-maze-iv\/","title":{"rendered":"Atrial Fibrillation: A Concern for Heart Valve Patients?"},"content":{"rendered":"<p>The realities of <a href=\"https:\/\/www.heart-valve-surgery.com\/atrial-fibrillation\/\">atrial fibrillation<\/a> are often misunderstood.\u00a0 People with AFib are 5 times more likely to have a stroke, according to the American Heart Association.\u00a0 AFib can greatly compromise a patient&#8217;s quality of life with debilitating symptoms including heart palpitations, chest pain, dizziness and fatigue.\u00a0 AFib is transforming into a global epidemic with a projected 300% growth rate of new AFib cases by 2030.<\/p>\n<p>When it comes to heart valve disease&#8230; The sobering realities of AFib are amplified.\u00a0 According to research from Northwestern Medicine, only 38% of patients with mitral valve disease get their AFib treated during heart surgery.\u00a0 As a result, AFib is often ignored, under-treated and mis-treated.<\/p>\n<p>To raise awareness to AFib for our patient community, we interviewed <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Marc-Gerdisch-Indianapolis-Indiana.php\">Dr. Marc Gerdisch<\/a>, Chief of Cardiac Surgery at Franciscan Health in Indianapolis, Indiana.\u00a0 So you know, Dr. Gerdisch is a heart valve and AFib expert who has successfully treated over 100 patients from HeartValveSurgery.com.\u00a0 In addition, Dr. Gerdisch teaches cardiac surgeons &#8211; all over the world &#8211; how to perform a successful Cox-Maze IV procedure, also known as a surgical ablation, during heart valve surgery to treat atrial fibrillation.<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/iSUwxblb7aQ\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<h2>Key Learnings About AFib and Heart Valve Disease<\/h2>\n<p>Here are several important points that Dr. Gerdisch shared during our interview:<\/p>\n<ul>\n<li>Dr. Gerdisch is a heart valve and AFib expert having performed over 6,000 cardiac procedures including more than 4,000 heart valve procedures.<\/li>\n<li>AFib is an irregular heart rhythm where the atria can move in a &#8220;chaotic&#8221; fashion.\u00a0 The consequences of atrial fibrillation are stroke due to a lack a normal blood flow through the atria.\u00a0 More specifically, the left atrial appendage is often responsible for the formation of blood clots in the heart.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-1629 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/gerdisch-maze-iv-procedure-afib.jpg\" alt=\"Dr. Marc Gerdsich Performing Maze Procedure\" width=\"600\" height=\"314\" \/>Dr. Marc Gerdisch Performing Heart Valve &amp; AFib Surgery<\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Other consequences of AFib are a decrease of cardiac output and symptoms.<\/li>\n<li>There is a higher incidence of atrial fibrillation for patients with heart valve disease. Dr. Gerdisch states, &#8220;The reason for that is largely because of the increased pressures in the atria, especially in the left atria &#8211; for example, with mitral valve disease. As the atrium expands, it becomes fibrotic, and as it fibroses, it becomes susceptible to atrial fibrillation. Atrial fibrillation is this irregular heart rhythm when there is substrate change in the muscle.&#8221;<\/li>\n<li>People who have atrial fibrillation can also induce changes in heart valve structures that ultimately results in cardiac disease.\u00a0 Dr. Gerdisch states, &#8220;For example, when the atrium enlarges &#8211; as a result of the atrial fibrillation &#8211; there are changes in the size of the mitral valve, and that valve will start to leak.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-1631 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/mitral-valve-leaking-afib.jpg\" alt=\"Leaking Mitral Valve Due to Atrial Fibrillation\" width=\"600\" height=\"337\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>In addition to the mitral valve, the tricuspid valve is susceptible to becoming regurgitant (leaky) due to atrial fibrillation because the tricuspid valve structure is thinner, lighter and less strong.<\/li>\n<li>AFib can and should be treated during heart valve surgery.\u00a0 (It is rare that AFib will resolve and &#8220;go away&#8221; if only the heart valve is fixed during surgery.)<\/li>\n<li>The Cox-Maze IV procedure is the best form of treatment for patients, according to Dr. Gerdisch.\u00a0 The benefits of the Cox-Maze IV procedure include decreased risk of stroke, cardiac output efficiency, lower risk of future valve disease, and decreased use of medications.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-1630 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/afib-surgical-ablation-benefits.jpg\" alt=\"Cox Maze IV - Patient Benefits\" width=\"600\" height=\"335\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Unfortunately&#8230; AFib is under-treated when people are having heart valve and coronary artery bypass graft (CABG) surgery.\u00a0 Reasons for under-treatment include: the Cox-Maze IV procedure adds some complexity to an operation and a lack of physician education \/ adoption.\u00a0 \u00a0To help educate cardiac surgeons about the benefits of the Cox-Maze IV procedure, Dr. Gerdisch has trained cardiac surgeons &#8211; around the world &#8211; on how to perform a successful heart valve and AFib treatment (which is referred to as a &#8220;concomitant&#8221; procedure).<\/li>\n<li>Dr. Gerdisch acknowledges several cardiac surgeons &#8211; Dr. James Cox, Dr. Ralph Damiano and Dr. Niv Ad &#8211; for their leadership in developing surgical techniques for successful AFib treatment.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Many Thanks to Dr. Gerdisch &amp; Franciscan Health!!<\/h2>\n<p>On behalf of our entire patient community, many thanks to Dr. Gerdisch for sharing his clinical experience and research with our community!\u00a0 Also, many thanks to the Franciscan Health team for taking such great care of heart valve patients.<\/p>\n<p>Related links:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Marc-Gerdisch-Indianapolis-Indiana.php\">See 125+ Patient Testimonials for Dr. Marc Gerdisch<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/atrial-fibrillation\/\">AFib &amp; Heart Valve Disease Patient Education Center<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/learning\/rapid-recovery-protocol-2-marc-gerdisch-dr\/\">Rapid Recovery 2.0: A New Approach to Pain After Heart Surgery<\/a><\/li>\n<\/ul>\n<p>Keep on tickin!<br \/>\nAdam<\/p>\n<p>P.S. For the hearing impaired members of our community, I have provided a written transcript of my video interview with Dr. Gerdisch below.<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"cms.php","meta":{"_acf_changed":false,"footnotes":""},"categories":[7],"class_list":["post-1615","page","type-page","status-publish","hentry","category-atrial-fibrillation-afib"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/1615","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/comments?post=1615"}],"version-history":[{"count":20,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/1615\/revisions"}],"predecessor-version":[{"id":5868,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/1615\/revisions\/5868"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/media?parent=1615"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/categories?post=1615"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}