(see also Ablation)

The MAZE procedure is used for the surgical treatment of atrial fibrillation (AF). Historically, a series of precise incisions were made to the right and left atria and sewn together again while on cardiopulmonary bypass. The scar tissue generated by the incisions permanently blocks the abnormal conduction pathways eliminating the arrhythmia. This procedure has since evolved to include the use of radio-frequency, cryoablation, or microwave energy. This is sometimes referred to as the “RF MAZE” procedure and is less time-consuming and easier than the “cut-and-sew” MAZE.

Minimally invasive procedures have also been successful in treating AF without the need for cardiopulmonary bypass. The procedure is done using video-assisted thoracoscopic access to the epicardial space. The right lung is collapsed, the right side of the heart is treated, and the lung is reinflated. The same procedure is repeated on the left. This procedure has been most successful in treating patients with paroxysmal AF, but now an exciting hybrid therapy is being used to treat chronic AF. This new approach uses a minimally invasive technique to create lines of ablation on the outside of the atria. Then, the left atrial appendage is removed to reduce the risk of stroke. A catheter-based ablation is completed approximately 3 months later, and additional ablation lines are added that cannot be performed surgically.