Maze Procedure for Atrial Fibrillation
The maze procedure is a method used to address atrial fibrillation (AFib), an irregular heartbeat. During this treatment, a surgeon utilizes heat, cold energy, or a scalpel to form a pattern of scar tissue in the heart's upper chambers, known as the maze. This scar tissue impedes the heart's electrical signals from passing through, effectively blocking aberrant signals that trigger AFib.
The maze procedure addresses atrial fibrillation (AFib), a form of irregular heartbeat, also known as an arrhythmia. If medications and other treatments have not effectively improved your AFib condition, your healthcare team might recommend the maze procedure as a potential solution.
Types of Maze Procedures
Surgical maze: This procedure involves heart surgery and necessitates using a heart-lung machine to maintain blood and oxygen circulation throughout the body. Also known as the Cox-maze procedure, it is often the preferred treatment for AFib in individuals requiring additional heart surgeries, such as heart valve procedures.
The surgical maze can be performed through two methods or a combination of the two methods:
Open-heart surgery: Where a sternotomy is made to access the heart for creating the maze using a scalpel, heat, or cold energy, or minimally invasive robotic surgery, which involves small incisions and robotic technology to reach the heart and only employs heat or cold energy to form the maze pattern. During the surgical maze, surgeons may also conduct other heart treatments or implant a pacemaker if necessary.
Catheter ablation maze: Is a treatment that uses thin, flexible tubes called catheters. The surgeon makes a cut to reach a blood vessel, usually in the groin area. The catheters go into the blood vessel. Then, they are moved to the appropriate location in the heart. Sensors on the end of the catheters give off heat or cold energy. The energy is used to create a pattern of scar tissue that blocks or redirects the faulty heart signals.
Mini-maze: At times, a combination of surgical and catheter techniques is employed to construct the maze, known as a mini-maze procedure or a hybrid approach.
Before the Procedure
You'll have tests to check your heart health to determine if the maze procedure is right for you.
During the Procedure
The maze procedure is most often done with medicines that put you in a sleep-like state. This is called general anesthesia.
During the maze procedure, a surgeon creates several specific lines in the heart using one or more of the following:
- A sharp tool called a scalpel.
- Heat energy, also called radiofrequency energy.
- Cold energy, also called cryothermal energy.
The pattern of lines created is called a maze. It scars over time. The scar tissue blocks or redirects the incorrect heart signals that cause irregular heartbeats.
There are different ways to reach the heart to do the maze procedure.
Results
The majority of individuals with atrial fibrillation (AFib) experience an enhanced quality of life following the maze procedure. However, there is a possibility of the irregular heartbeat recurring. In such cases, medication or a repeat maze procedure may be necessary. Should your heartbeat slow down excessively post-maze procedure, your healthcare team may recommend the placement of a pacemaker.