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, which does not conduct electrical activity,
blocks the abnormal electrical signals causing the arrhythmia. The scar tissue
directs electric signals through a controlled path, or maze, to the lower heart
The maze procedure might be done during
open-heart surgery. It is commonly done for people with atrial fibrillation if they are having an open heart surgery for another reason. A maze procedure may
also be done with less invasive techniques.
The maze procedure is frequently performed with
other necessary cardiac surgery, such as
coronary artery bypass and valve repair or
What To Expect After Surgery
Recovery for a maze procedure depends on how your surgery was done. For example, recovery will likely be longer for an open-heart procedure than for a less invasive procedure.
You may have to stay in the hospital
for about 7 to 10 days. Most people spend the first 2 or 3 days after surgery
in an intensive care unit (ICU) where they can be closely watched. You will
be encouraged to walk within 1 to 2 days of your surgery.
Discomfort in the chest, ribs, and shoulders is common within the first
several days following surgery. Your doctor will order pain medicines to help
control this discomfort.
Medicines called diuretics are used to
control fluid buildup right after surgery. Your doctor may have you take
a diuretic at home for several weeks following surgery.
need to take an
anticoagulant, such as warfarin (Coumadin, for
example), after the procedure. But this is usually determined on a case-by-case
Recovery is typically complete within 6 to 8 weeks
following surgery. Some people have discomfort at the chest incision for
several months after surgery.
You will be able to get back to
your normal activities within 3 months. You may feel more tired than
usual, but most people are back to normal within 6 months.
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.
may recommend the maze procedure if at least one of the following descriptions
is true about you:1
- Rhythm-control medicine has not worked to relieve your symptoms from atrial fibrillation.
- You have symptoms of atrial fibrillation, and you are having another
- You are having another heart surgery, and adding the
maze procedure is not too risky.
- You cannot have catheter
ablation, or you prefer to have surgery.
- You have already had catheter ablation, but you still have
How Well It Works
The maze procedure has good long-term
results for treating atrial fibrillation. It can stop atrial fibrillation in about 7 to 9 people out of 10. But 1 to 3 people out of 10 still need to take medicines to control their heart rhythm.2
The risks of the maze procedure are similar to
the risks of any heart surgery that uses a heart-lung bypass machine.
(myocardial infarction, or MI).
- New arrhythmias.
- Needing to have a
- Death. (About 1 or 2 deaths happen out of 100 surgeries.2)
What To Think About
You may need to have a blood
transfusion following the maze procedure. Talk with your doctor and find out
whether it is possible for you to donate your own blood to be used during the
The maze procedure is very
expensive and may not be covered by your health insurance. It is only available
at specialty medical centers.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
Calkins H, et al. (2012). 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: Recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. A report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation. Heart Rhythm, 9(4): 632–696.e21.
Morady F, Zipes DP (2012). Atrial fibrillation: Clinical features, mechanisms, and management. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 1, pp. 825–844. Philadelphia: Saunders.
Primary Medical Reviewer
||Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Specialist Medical Reviewer
||John M. Miller, MD, FACC - Cardiology, Electrophysiology
Current as of
||March 12, 2014