Atrial fibrillation (AFib) is the most common heart rhythm disorder, and those who are diagnosed with it carry significant health risks, including a risk of stroke that requires lifetime management through blood thinners.
Some patients may benefit from certain minimally-invasive procedures to correct AFib, enabling them to go off blood thinners and reducing their risks of potentially deadly complications. In those cases, the Maze procedure, offered at Georgia Heart Institute through the cardiovascular and thoracic surgeons of Northeast Georgia Physicians Group, may be a great solution to help patients correct AFib.
What is the Maze procedure?
The Maze procedure, sometimes called the Cox-Maze procedure (CMP) after Dr. Cox, who developed the approach, involves creating scar tissue, or lesions, in a maze pattern on the upper heart chambers. We typically use a device that delivers freezing temperatures to the tissue to create the scar tissue. After that scarring pattern is created, it prevents the tissue from conducting electricity, effectively stopping the stray electrical currents that keep the heart out of rhythm.
Endoscopic robotic Maze procedure
The Maze procedure is often considered the “gold standard” in AFib treatment, but traditionally it’s been performed through open heart surgery, making it a poor option for some high-risk patients and a less-preferrable option for others who are worried about pain and long recovery times.
In open heart surgery, the breast plate must be divided and spread for the surgeon to access the heart, but at Georgia Heart Institute we can perform this procedure through an endoscopic robotic approach, requiring only a few small incisions. We also take a different approach to stopping the heart, which can benefit patients where there is concern about using an Impella pump. Finally, if a patient is also suffering from another heart condition, like mitral valve regurgitation or issues requiring a left atrial appendage closure, we can correct both issues at the same time, using the robotic approach.
Frequently asked questions
Because the Maze procedure is heart surgery, it’s typically recommended to patients for whom other, less invasive approaches did not work. That includes:
- Patients who already need heart surgery – in these cases a cardiovascular surgeon can often perform the Maze procedure at the same time.
- Patients who cannot take blood thinners or medication for AFib.
- Patients who’ve experienced a stroke and want to head off further complications.
- Patients who had an unsuccessful cardioversion or cardiac ablation to treat AFib.
The two procedures are similar, but one is more comprehensive than another! During a catheter ablation, a thin tube (catheter) is inserted through a blood vessel and threaded to the heart. Then a specially-trained cardiologist use a tool in that catheter to create scar tissue in specific areas on the heart.
The Maze procedure is done surgically, rather than through a catheter, to create a large maze-like pattern of scar tissue that goes across both the right and left atria of the heart. A Maze procedure would be a next step if a catheter ablation has failed or it may be recommended from the start if the patient has other heart problems that would require surgery or has a more significant stroke risk.
When it comes to heart care, it can be challenging to navigate the care options and choose what is best for you or your loved one. If you are considering surgery for Afib, we recommend bringing a family member or friend with you to an appointment. Consider what goals you have for your health and lifestyle and share those with your cardiologist. Finally, choose a provider who can help you assess all of the latest options, including minimally-invasive and robotic surgery, and can refer to you a cardiologist or surgeon with expertise in these procedures.
The Maze procedure has high success rates, curing AFib in 80 – 90% of patients. At Georgia Heart Institute, we aim to provide the effective approach for each patient, while limiting pain and long recovery times, which is why we focus on robotic surgeries where no sternum-spreading is needed.
Unless a patient is particularly high risk, we typically perform a complete Maze procedure, which means we create scar tissue across both the left and right atria, to provide the most effective long-term treatment for the patient.
Connect with our program
Referrals are required for surgical services, but our knowledgeable team of experts is always happy to answer your questions and provide next steps. Call 770-219-7099 to discuss your surgery with our team.
If you are a clinician who needs to refer a patient for cardiothoracic surgery, please contact our program directly at 770-219-7099. Our program coordinator can answer any questions you have and help schedule your patient to see one of our board-certified cardiothoracic surgeons.