In order for the heart to beat, it receives electrical stimulation or signals that starts 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 for atrial fibrillation is an option for individuals with:

• Atrial fibrillation despite medical treatment
• Severe symptoms
• Need for heart or valve surgery
• Heart failure

The Maze procedure is an effective surgical treatment that creates electrical blocks or barriers in the upper heart chambers (atria), forcing electrical impulses that stimulate the heartbeat to travel to the lower chambers (ventricles). Like a maze puzzle, abnormal electrical signals are forced to move along one path, in one direction, to the lower chambers, restoring the heart rhythm and the pumping of blood to normal.

The original Maze procedure, first performed in 1987, created "blocks" through carefully placed incisions that were then sewn back together.  The incisions generated scar tissue that served as the barrier.

Since that time, the Maze procedure has evolved. Physicians are continually discovering new sources of energy to create these lines of scar in the heart. These new tools shorten the procedure time, making it easier to perform this surgery with other heart operations. In some cases, the scar lines may be placed without using a heart-lung machine.

Depending on the type of atrial fibrillation surgery your surgeon performs, you will receive either an incision down the middle of the chest (sternotomy), or small incisions on the sides of the chest (thoracotomy). Your physician will discuss the Maze procedure that best matches your particular surgical needs.

Risk

Every surgery carries some risk. The amount depends on such factors as your age and overall health. In some cases, a pacemaker or other procedures may be needed. Your surgeon will discuss individual risks with you.

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.

< Blood clot removal from the atria to reduce stroke risk .
Please note: this video may be graphic in nature.

Multidisciplinary Approach

Because atrial fibrillation is a complex disease, the Center for Atrial Fibrillation offers a multidisciplinary approach to the diagnosis and treatment of patients with atrial fibrillation. After carefully reviewing the patient's medical history and cardiac evaluation, the surgeons will discuss their recommendations for surgical treatment options with the patient and the patient's referring physician and/or cardiologist. Incorporating the patient's referring physician and/or cardiologist into the delivery of care is highly endorsed and practiced by the Center for Atrial Fibrillation.

Clinical Research

Clinical research trials at the Center for Atrial Fibrillation focus on understanding the factors that predispose patients to atrial fibrillation and in developing new, less invasive means of treating atrial fibrillation. The Center for Atrial Fibrillation also incorporates the collection of data on each patient treated surgically for atrial fibrillation with the Maze procedure into a clinical database that evaluates the long-term effects of this surgical procedure. This collection of data allows for accurate evaluation of treatment outcomes so that the Center for Atrial Fibrillation can continue to provide the best treatment options to patients.

Contact

For more information regarding surgery for atrial fibrillation, please call the Bluhm Cardiovascular Institute at 1-866-662-8467 or request a first time appointment online.