Medically Reviewed by S. Cary Huber, MD
Problematic heartbeats caused by electrical misfires can be treated a number of ways – with medication, ablation, as well as with a surgical treatment called MAZE. McLeod Cardiothoracic Surgeon Cary Huber, MD, explains how MAZE is accomplished:
Here are highlights form Dr. Huber’s comments:
The surgical procedure for dealing with atrial fibrillation is referred to as the MAZE procedure. It was developed in the early 1990s by a physician named Dr. James Cox. Originally, it involved cutting a series of incisions with a knife and scissors through the atria – the upper chambers of the heart – to eliminate or correct the abnormal electrical pathways.
New technologies have been developed that have allowed us to create these same pathways without cutting into the heart, for the most part. We use different technologies. Either freezing sections of the heart, or burning with radio frequency, to create these lesions, interrupting the abnormal connections and, thereby, eliminating the atrial arrhythmia.
As an additional component of the MAZE procedure, we remove the portion of the heart where most of the clots develop that can cause debilitating strokes from atrial fibrillation.
It’s a very common arrhythmia. And if someone is having a cardiac bypass operation or a valve procedure, we’ll very frequently add the MAZE onto that other procedure as an additional procedure.
Atrial fibrillation can lead to heart failure. It can also lead to premature death.
It’s a “nuisance” arrhythmia that is, in fact, a serious arrhythmia. Also, a significant number of the people who have atrial fibrillation will have adverse reactions to either the medications that are used to control it or the blood thinners. Specifically, there’s a significant incidence of bleeding from the blood thinners. If the arrhythmia can be eliminated, so can the need for the powerful anti-arrhythmic drugs and the blood thinners.
There are lifestyle changes imposed on people that have afib, particularly, if they need to be on blood thinners. The blood thinners can require you to have your blood thinner level checked occasionally and also place you on a large list of medications.
If the MAZE procedure is successful – either with the cardiologist’s ablation or surgically – the hope is for the patient to get off their blood thinners and their anti-arrhythmic medications.
For surgical MAZE, the success rate is over 90%. Most people that have a MAZE procedure will go in and out of afib for the first several months after their surgery. But at the six-month follow-up, 90% of them are in a regular heart rhythm and off their blood thinners.
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