Robert Wood Johnson University Hospital

Robert Wood Johnson University Hospital Introduces New Atrial Fibrillation Procedure

Innovation Offers Patients Better Recovery Without Open Heart Surgery

Robert Wood Johnson University Hospital (RWJUH), nationally renowned for the excellence of its cardiac programs, now offers a minimally invasive surgery to treat atrial fibrillation, an irregular heart beat that can leave the patient out of breath, weak and at increased risk of stroke.

Called minimally invasive microwave ablation, the new surgery provides an alternative for patients who would otherwise face major cardiac surgery or a lifetime of medication.

RWJUH performed New Jersey's first minimally invasive thoracoscopic microwave ablation procedure for atrial fibrillation last week.  The patient, a 56-year-old Metuchen man, was released from the hospital on Tuesday, October 4.

"We are now able to disrupt the electrical impulses causing the irregular heart beat and promote normal rhythm without major surgery," said Peter M. Scholz, MD, chief of the Division of Cardiothoracic Surgery at Robert Wood Johnson University Hospital and at UMDNJ-Robert Wood Johnson Medical School.  "Over time, the patient should experience a return of the energy and stamina sapped by atrial fibrillation. For many, this is the first step towards a better quality of life."

Traditionally, the surgical treatment for atrial fibrillation, known as the Cox-Maze procedure, involved a major operation. Doctors cracked the breastbone and stopped the heart, putting the patient on a heart-lung machine. Recovery time was extensive.

As a result, the procedure was generally only performed on patients in conjunction with other planned cardiac surgery, such as valve repair and coronary artery revascularization.

Now, however, patients can realize the benefits of the Maze operation in a stand-alone procedure, without undergoing a major, open-heart operation.

In thoracoscopic microwave ablation, the surgeon gains access to the heart through a series of keyhole-sized incisions on the sides of the chest.

About 2.4 million Americans suffer from atrial fibrillation, making them five to seven times more likely to have a stroke.

heart comparison

In atrial fibrillation, the electrical signals from the upper chambers of the heart (the atria) are fast and irregular, causing the atria to quiver instead of beating effectively.   To fix it, surgeons seek to isolate the electrical signals causing the problem. This is typically done by creating a lesion or burn around the atrium through microwave energy.  If successful, the resulting scar tissue will prevent the abnormal electrical impulses from affecting the rest of the heart.

Making use of a tiny video camera to guide small instruments, surgeons at RWJUH loop a catheter, a thin plastic tube, around the heart. To allow better access to the heart, each lung is temporarily deflated in turn to allow the catheters to be threaded around the pulmonary veins. When the catheter is activated with microwave energy, it creates a lesion around the atrium that will scar and block the electrical impulses causing the irregular heart beat.

"The procedure takes a few hours using general anesthesia but does not require use of a heart lung machine as in traditional open heart surgery. The risk of complications with this procedure is much less than those associated with open heart surgery," said Dr. Scholz.

The minimally invasive Maze procedure is the latest in cardiac innovations RWJUH has introduced to New Jersey. For example, earlier this year RWJUH introduced left ventricular assist devices for long-term use in patients with severe heart failure.   RWJUH also is one of the first New Jersey hospitals to treat heart attack patients with angioplasty, rather than clot-busting drugs.

For more information, call The Heart Center of New Jersey at (732) 418-8030.

About Robert Wood Johnson University Hospital

Robert Wood Johnson University Hospital (RWJUH) is a 600-bed academic medical center and the principal hospital of Rutgers Robert Wood Johnson Medical School in New Brunswick, N.J.

RWJUH is an innovative leader in advancing state-of-the-art care. Its Centers of Excellence include cardiovascular care, from minimally invasive heart surgery to transplantation; cancer care; and women’s and children’s care, including The Bristol-Myers Squibb Children’s Hospital (

The hospital is a Level I Trauma Center and serves as a national resource in its ground-breaking approaches to emergency preparedness.

RWJUH has earned significant national recognition for clinical quality and patient safety. It ranks among “America’s Best Hospitals,” according to U.S.News & World Report’s 2012 survey; it is the sixth consecutive year that RWJUH has achieved this prestigious ranking. Also in 2012, U.S.News & World Report ranked BMSCH among the nation’s “Best Children’s Hospitals.” The American College of Surgeons’ Commission on Cancer has rated RWJUH among the nation's best comprehensive cancer centers. The Leapfrog Group rated RWJUH among the 50 exceptional U.S. hospitals, as published in Consumers Digest, and has given the hospital an “A” grade for safety and quality. Harvard University researchers, in a study commissioned by The Commonwealth Fund, identified RWJUH as one of the top 10 hospitals in the nation for clinical quality. RWJUH is a four-time recipient of the prestigious Magnet Award for Nursing Excellence

Attention members of the media: For more information on this release, please contact the Department of Public Relations (732) 937-8521.


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