Stanford Cardiac Arrhythmia Service

Atrial Fibrillation Surgery (Maze)

This procedure is performed by an electrophysiologist, unless it is done in conjunction with another heart surgery, in which case it is performed by a cardiothoracic surgeon.

The MAZE procedure is not necessary in most patients with atrial fibrillation (AF). Many patients are not bothered by the irregular rhythm or the medications required to control it. In some cases, cardiologists are able to disrupt the irregularity.

Some patients, however, are so troubled by the way they feel when they are in atrial fibrillation or by the side effects of their medications they must take that a surgical option is appropriate.

In addition, individuals in atrial fibrillation who have experienced a stroke are at significant risk for another stroke. The MAZE procedure may be the preferred treatment in these patents, as well.

The procedure

During the procedure, the physician makes a number of incisions on the left and right atria to form scar tissue. This scar tissue interrupts the path of abnormal electrical impulses that are causing AF. The scar tissue also prevents erratic electrical signals from recurring.

The result is that the unwanted path is cut off, and there is only one path that the electrical impulse can take from the SA node to the AV node. The atrium can no longer fibrillate, and the normal heart rhythm is restored. Maze can be performed either through an open chest procedure or a minimally invasive procedure.

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