Surgery Overview

The maze procedure is a surgical treatment for atrial fibrillation. It can also be called a surgical ablation.

The surgeon can use small incisions, radio waves, freezing, or microwave or ultrasound energy to create scar tissue. The scar tissue doesn't conduct electrical activity. It blocks the abnormal electrical signals that cause the arrhythmia. The scar tissue directs electric signals through a controlled path, or maze, to the lower heart chambers (ventricles).

The maze procedure can be done in different ways. It may be done through small cuts in the chest. Or it may be done during open-heart surgery.

The maze procedure may be done if a person is having another heart surgery, such as coronary artery bypass and valve repair or replacement.

What To Expect

Recovery from a maze procedure depends on how your surgery was done. Recovery will likely be longer for an open-heart procedure than for a less invasive procedure.

You may stay in the hospital for a few days. Most people spend the first 1 or 2 days in an intensive care unit (ICU).

You will likely feel tired and sore for the first few weeks after surgery. You may have some brief, sharp pains on either side of your chest. Your chest, shoulders, and upper back may ache. The incision may be sore or swollen.

If your breastbone (sternum) was cut, you will probably be able to do many of your usual activities after 4 to 6 weeks. But for at least 6 weeks, you will not be able to lift heavy objects or do activities that strain your chest or upper arm muscles.

Why It Is Done

The maze procedure is a surgical treatment for atrial fibrillation. It is used to control the irregular heartbeat and restore the normal rhythm of the heart.

Your doctor may recommend the maze procedure if at least one of the following descriptions is true about you:^{footnote 1, footnote 2}

• Rhythm-control medicine has not worked to relieve your symptoms from atrial fibrillation.
• You have symptoms of atrial fibrillation, and you are having another heart surgery.
• You are having another heart surgery, and adding the maze procedure is not too risky.
• You can't have catheter ablation, or you prefer to have surgery.
• You've already had catheter ablation, but you still have atrial fibrillation.

How Well It Works

The maze procedure has good long-term results for treating atrial fibrillation. It can stop atrial fibrillation in about 9 people out of 10.^{footnote 3} You may need to take heart rhythm medicine (antiarrhythmics) after the procedure.

Risks

The risks of the maze procedure are similar to the risks of any heart surgery that uses a heart-lung bypass machine.

Risks include:^{footnote 2}

• Bleeding.
• Infection.
• Stroke.
• Pneumonia.
• Heart attack (myocardial infarction, or MI).
• New arrhythmias.
• Needing to have a pacemaker implanted.
• Death. (About 1 or 2 deaths happen out of 100 surgeries.^{footnote 3})