In order for the heart to beat, it receives electrical stimulation or signals that start in the atria or upper chambers of the heart and then travel down to the ventricles or lower chambers of the heart. Atrial fibrillation is defined as chaotic or abnormal electrical signals or pathways in the atria resulting in an irregular heartbeat. The irregular heartbeat does not allow the atria to contract or squeeze normally, rather the atria quiver decreasing the amount of blood ejected from the heart with each heartbeat.
Surgery to cure atrial fibrillation is routinely performed at the Center for Atrial Fibrillation by cardiac surgeons Patrick M. McCarthy, MD and Richard Lee, MD. The Maze procedure is regarded as the "gold standard" to provide the most effective cure for atrial fibrillation. In addition to the classic Maze procedure, other types of atrial fibrillation surgery are also available at the Center for Atrial Fibrillation.
Surgery for atrial fibrillation is an option for individuals with:
During atrial
fibrillation, blood clots may form inside the heart, most often in the
left atrial appendage - a small pocket of tissue in the left atria. If the blood
clot breaks free, the clot can travel to the brain and cause a stroke. 
Removing a clot from the atrial appendage reduces stroke risk. Please note: this video may be graphic in nature.
Traditional or Classic Maze Procedure
The traditional or classic Maze procedure is the traditional approach also referred to as the "cut and sew" Maze. During this procedure, multiple incisions are made in the right and left atria to isolate abnormal electrical stimulation or signals. These incisions are then sewn closed. As the incisions heal, a scar is formed preventing conduction of abnormal electrical signals that trigger atrial fibrillation. Because the incisions are made on the inside of the heart, patients need to be on a heart-lung or "bypass" machine during the surgery. This procedure is usually performed using a 6-8 inch incision down the center of your chest (sternotomy).
At the Center for Atrial Fibrillation, the procedure can often be performed with a smaller 3-5 inch incision (mini-sternotomy).
When mitral valve repair or other heart surgery is also required the "cut and sew" approach is often combined with energy sources, like radiofrequency and cryo, that allow surgeons to quickly create scars in the atria. This shortens the time to make the pattern of scars that prevents abnormal electrical signals. The scars are made on the inside of the heart and the heart-lung machine or "bypass" machine is required during the surgery.
Mini-thoracoscopic Approach
Also, utilized at the Center for Atrial Fibrillation is the mini-thoracoscopic approach (simplified Maze) performed by Dr. Lee.
Dr. Lee places scar lines around the pulmonary veins to isolate abnormal electrical signals from the outside of the heart via small incisions on the sides of the chest. This procedure is performed on the beating heart. Many energy sources such as radiofrequency, cryo, laser ultrasound, and microwave are available to create scars from the outside of the heart.
Hybrid Maze
The Hybrid Maze is performed in two stages. Stage I, is the mini-thoracoscopic approach (simplified Maze) performed by Dr. Lee and Stage II, is a minimally invasive catheter ablation performed in the Electrophysiology Laboratory by specially trained cardiologists called electrophysiologists. Each procedure is responsible for placing scar lines in very specific places in and around the heart to isolate abnormal electrical signals that cause atrial fibrillation. Stage I places scar lines around the pulmonary veins from the outside of the heart via small incisions on the sides of the chest with energy sources such as radiofrequency, cryo, laser, ultrasound, and microwave. Stage II, catheter ablation, places scar lines in the upper chambers or atria of the heart from the inside of the heart with energy sources similar to those used in Stage I.
After Stage I, the patient returns home and is monitored for approximately one month to see if the atrial fibrillation returns. Stage I can be up to 90 percent effective for certain types of atrial fibrillation. Patients with other types of atrial fibrillation may require Stage II. Hybrid Maze Performed by Dr. Lee Featured on OR-Live. Please note: this video may be graphic in nature.
The addition of these innovative technologies allows the simplified Maze and the Hybrid Maze to be done quickly, minimally invasively, and without a heart-lung or "bypass" machine. These highly effective treatments result in a quicker recovery, a shorter hospital stay, and opens the door to surgical cure options for a wider segment of the 2.4 million Americans with atrial fibrillation.
Contact
For more information regarding the Maze procedure call the Center for Atrial Fibrillation at (866) 662-8467 (toll free), or request an appointment online.
Visit the Northwestern Memorial Hospital's Health Learning Center and Alberto Culver Women's Health Learning Center.
These state-of-the-art health information libraries are among the
largest hospital-based learning facilities of their kind. For more
information call (312) 926-5465.
Maze Procedure
Before surgery
Day before your surgery
Day of surgery
During surgery
After surgery
Review Date: 08/07
