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 - Northwestern Memorial Hospital - Chicago

Hybrid Maze Procedure for Atrial Fibrillation

The Hybrid Maze is a minimally invasive procedure for treatment of atrial fibrillation, pioneered by Northwestern Memorial’s surgeons and electrophysiologists. It is performed in two stages, both of which create scar lines in specific places in and around the heart. These scars isolate abnormal electrical signals that cause atrial fibrillation and redirect them, restoring the heart rhythm and normal blood flow. By using this approach, all the lesions of the “classic” or cut and sew” Maze can be created without a sternotomy (a long incision along the flat bone in the middle of the chest). 

The Hybrid Maze procedure:

  • Is less invasive than traditional atrial fibrillation procedures (“classic” or “cut and sew” Maze)
  • Does not require a sternotomy or use of a heart-lung “bypass” machine
  • Offers shorter recovery times

Hybrid Maze: Stage I

In Stage I, Richard Lee, MD, a cardiac surgeon and surgical director of the Program for Atrial Fibrillation, places scar lines around the pulmonary veins from the outside of the heart through small incisions on the sides of the chest.

The scars are created using radiofrequency energy. This allows the surgeon to operate on the beating heart, eliminating the need for a heart-lung “bypass” machine.

During the procedure, surgeons also use a clamp to isolate the left atrial appendage (a pocket-like section in the left atrium)—often a key source of blood clot formation and stroke—and remove it.

After Stage I, patients return home and are monitored for about one month to see if atrial fibrillation returns. Stage I can be up to 90 percent effective for some types of atrial fibrillation. Overall, approximately two out of three patients will only require Stage I. In the patients for whom Stage I is not enough, Stage II is recommended.

Hybrid Maze: Stage II

In Stage II, specially trained cardiologists called electrophysiologists perform a minimally invasive catheter ablation in our electrophysiology laboratory.

During the procedure, electrophysiologists create more scar lines in the upper chambers (or atria) of the heart. Mapping systems are used to find gaps in the barriers placed during Stage I. Scar lines are made from the inside of the heart using energy sources similar to those used in Stage I. Identifed gaps are closed and scars that can only be made from inside the heart are created.

By combining procedures performed by two types of cardiac experts, our team can re-create the lesions of the “classic” or “cut and sew” Maze without the use of a sternotomy. This offers patients a faster recovery with results similar to those of the traditional, more-invasive procedure.

Contact Us Today

For more information regarding atrial fibrillation, please call the Bluhm Cardiovascular Institute at 312-694-AFIB (2342) and ask to speak with one of our dedicated atrial fibrillation nurses. Jane Kruse and Mary Navarrete can provide information, answer questions and assist you with treatment options that best fit your needs. You can also request a first-time appointment online.

Clinical Trials and Quality Ratings

For more information regarding clinical trials related to atrial fibrillation, please visit the Clinical Trials Unit of Northwestern, send an email or call 312-926-4000.

Our quality ratings provide detailed information about data we have collected about our healthcare performance. View our quality ratings related to atrial fibrillation.

Last UpdateMarch 5, 2014