In the auditorium of Beijing Anzhen Hospital, doctor Randall K. Wolf demonstrated to a few hundred Chinese patients the state-of-the-art atrial fibrillation (AF) surgery technology on April 11.

Doctor Randall K. Wolf performs magic after demonstrating surgery technology in Beijing Anzhen Hospital.

The president of the International Society for Minimally Invasive Cardiothoracic Surgery and professor in Cardiothoracic Surgery with University of Cincinnati College of Medicine brought a novel operation idea called the "Mini-Maze".

AF is one of the most common types of abnormal heart rhythm encountered clinically, affecting about 9 million Chinese, according to professor Meng Xu of the heart surgery department of Beijing Anzhen Hospital.

Characterized by a rapid, irregular heartbeat, AF is due largely to abnormal electrical impulses that cause the atria of the heart to quiver when it should be beating steadily, Wolf explained.

As a result, blood flow is reduced. It is not completely pumped out of the two small upper chambers of the heart and the atria, allowing the blood to pool and potentially clot. The biggest risk from AF is stroke, Wolf said.

Medical checkups can spot abnormalities in the heart's rhythm before any obvious symptoms are noticed, he noted.

The "Mini-Maze" that Wolf developed in 1999 is an interventional procedure to treat AF. So far, he has already treated more than 500 cases.

Doctor Wolf is also a magician who performs big stage shows or close-up magic before audiences. He has devised magic props for David Copperfield.

"Surgeons and magicians are a lot alike - using their hands to do every step perfectly and almost without thinking," he said.

Unlike the conventional open heart surgery, AF surgery only opens small incisions between the patient's ribs. Then a special clamp is navigated by a micro-miniature television camera so that the doctor can actually see the heart without opening the chest.

The doctor then uses the clamp to make burn scars to halt the chaotic electrical impulses and electrically isolate the pulmonary veins, where the triggers are located that activate AF. A second part of the procedure is the endoscopic exclusion of the left atrial appendage, a useless "thumb-like" structure of the heart that can host clot formation and lead to a stroke.

"The procedure allows patients to undergo a less invasive surgery to treat their AF and recover faster than traditional surgery," Wolf said.

Doctor Meng of Anzhen Hospital said minimal invasive procedures for AF are only at a starting stage in China. Learning from advanced international technologies could renew their treatment concept, he said.

(China Daily April 23, 2007)