The Maze Procedure
The maze procedure is a surgical treatment for atrial fibrillation. It creates scar tissue barriers that block the stray electrical impulses that cause the extra contractions, symptoms, circulation problems, and damage caused by atrial fibrillation.
How It Works
In the procedure, the cardiovascular surgeon uses ablation to create the tiny blockage scars in the heart muscle of the atria. The scarring is done in an intricate pattern, or a “maze.” Because the scars block electrical signals, they deter the “stray” electrical impulses that are causing the atrial fibrillation. The “true” electrical signal can then follow only one correct path (through the maze) to create the desired normal heart rhythm. A regular, coordinated heartbeat is restored.
Several different approaches to the maze procedure have been developed, including an open-heart surgery approach and minimally invasive approaches with or without the use of a surgical robot. Likewise, different tools have been developed to create the scar tissue, including radiofrequency ablation, cryoablation, ultrasound ablation, and microwave ablation technologies. The maze procedure may also be performed in conjunction with another surgery, such as CABG or mitral valve repair.
The advantages of the maze procedure are that it:
- Corrects atrial fibrillation
- Restores normal heart rhythm
- Allows an enlarged atrium to return to normal size
- Allows most patients to stop taking blood-thinning medications
- Decreases the risk for blood clots and/or stroke
- Decreases fainting or dizziness
The risks of the procedure vary based on the approach used and the health conditions of the individual patient. Risks should always be discussed with the surgeon prior to any surgical treatment.
Some centers have reported an 80% to 100% success rate in restoring normal sinus rhythm with the maze procedure. Some patients require insertion of a pacemaker after having the maze procedure.
Mayo Clinic www.mayoclinic.org/maze-heart-surgery/index.html
The Society of Thoracic Surgeons www.sts.org/doc/4511
Cleveland Clinic www.clevelandclinic.org/heartcenter/pub/atrial_fibrillation/maze.htm