Maze Procedure for Atrial Fibrillation

Heart surgeons at UT Southwestern Medical Center have extensive experience performing the maze procedure to treat atrial fibrillation (AFib), a potentially dangerous heart rhythm disorder.

By physically disrupting tiny spots in the heart where AFib originates, the maze procedure helps to restore a normal heart rhythm to patients who have unsuccessfully tried other treatments.

Advanced Surgery for a Serious Heart Disorder

The maze procedure is used to treat atrial fibrillation, a potentially dangerous heart rhythm disorder.

In a normal heart rhythm, the electrical impulse that makes the heart muscle contract originates in the heart’s SA node (the “pacemaker”) in the right atrium. The impulse travels to the AV node – which makes the atria contract – and then to the ventricles for contraction.

In atrial fibrillation, the electrical signal doesn’t travel properly from the SA node to the AV node. Instead, it localizes in one region, causing the atrium to rapidly and irregularly contract (fibrillate) instead of contracting evenly.

AFib often can be treated without surgery, but the maze procedure can be used when nonsurgical therapies have failed.

Respected by their peers as experts in treating cardiac arrhythmias, UT Southwestern’s team of cardiologists includes heart rhythm management specialists with extensive experience with the maze procedure.

Maze Procedure: What to Expect

Pre-Procedure Details

The surgeon will provide specific instructions to the patient prior to the maze procedure and explain risks such as bleeding, infection, or adverse reaction to anesthesia.

Patients will also meet with the anesthesiologist prior to the surgery to review their medical history. Patients should not eat after midnight the night before the surgery.

On the day of surgery, the patient arrives at the hospital, registers, and changes into a hospital gown. A nurse reviews the patient’s charts to make sure there are no problems.

The anesthesiologist then starts a local anesthesia IV, and the patient is taken to the operating room, where the surgeon verifies the patient’s name and procedure before any medication is given. The procedure begins once the anesthesia is in effect.

Procedure Details

The surgeon begins by making a long incision in the breastbone and spreading the ribcage to access the heart. The patient is then put on a cardiopulmonary bypass machine, which pumps oxygenated blood through the body, bypassing the heart and lungs during the operation.

The surgeon then makes multiple small incisions on the atria, disrupting the “bad” circuits that disturb the normal flow of electrical impulses. These incisions create a maze that gives electrical impulses only one correct path to travel from the SA node to the AV node.

The incisions are then sewn back together to prevent blood leakage through the atria. Once the heart is restarted, the cardiopulmonary bypass machine is removed and the chest is closed using stitches or staples.

Post-Procedure Details

After surgery, patients are taken to the intensive care unit and monitored. Pain is likely, and pain medication is given as needed.

Patients have chest tubes to drain excess fluids from the chest cavity after surgery. They also are on a respirator to help them breathe until they can breathe on their own, and they are not able to speak during this time.

The length of the hospital stay depends on how quickly patients are able to recover and perform some physical activity.

Support Services

UT Southwestern’s cardiac rehabilitation specialists create customized plans that integrate proper nutrition, exercise, and, if necessary, nicotine cessation into patients’ lifestyles to improve their cardiovascular health.

Clinical Trials

As one of the nation’s top academic medical centers, UT Southwestern offers a number of clinical trials aimed at improving the outcomes of patients with cardiovascular disease.

Clinical trials often give patients access to leading-edge treatments that are not yet widely available. Eligible patients who choose to participate in one of UT Southwestern’s clinical trials might receive treatments years before they are available to the public.