Surgery for AFib patients helps get heart rhythm back on track

The maze procedure is a highly effective treatment for patients with atrial fibrillation (AFib), a disturbance of the heart rhythm (arrhythmia), and for those whose AFib is not responding well to medication. At Lankenau Heart Institute the procedure can be done minimally invasively during mitral or aortic valve surgery, as an isolated procedure or as traditional open-heart surgery. The goal of the maze procedure is to interrupt the electrical impulses that are responsible for the chaotic rhythm of atrial fibrillation and create a new pathway, or maze, through which electrical impulses travel. This restores normal heart rhythm and prevents arrhythmia-associated complications.

How maze surgery is done

Minimally invasive maze surgery may be performed via a catheter (thin tube) that gets inserted through a small incision (cut) outside the heart or performed with robotic assistance through small cuts on your chest, in between your ribs. Your surgeon then uses a radiofrequency device or cryo technology to create lesions on the atria (the two small heart chambers). The lesions interrupt the erratic electrical impulses, controlling the “fibrillation” or fluttering of the heart.

An open-heart maze procedure involves use of a heart-lung machine that allows the cardiac surgeons to stop your heart so they can perform the surgery. The heart-lung machine does the work of your heart while you’re in surgery. The surgeons make incisions in both the right and left atria of the heart. When the incision heals, scar tissue forms and prevents electrical impulses from passing through the heart. Lankenau offers the maze procedure on its own or as part of a “hybrid” procedure where valve surgery or coronary artery bypass surgery (CABG) are performed at the same time.

Risks and recovery from maze surgery

Maze surgery is performed under general anesthesia meaning you’ll be asleep during the surgery and will not feel anything. The surgery generally takes two to three hours. As with any surgical procedure, there are certain risks, such as problems with anesthesia, or bleeding and infection at the incision site after surgery. Your doctor will discuss the potential risks and benefits with you before your procedure.

Your recovery time will depend on whether you have open-heart maze surgery or robotic maze surgery. With the open-heart approach, you may be required to stay in the hospital 10 to 12 days vs. two to three days for minimally invasive maze surgery. For either type of surgery, you can expect a recovery time of six to eight weeks. Each person’s recovery depends on a variety of factors, including age and current health condition.

While the maze procedure can significantly improve atrial fibrillation, some patients find that the AFib returns within a few months. Usually, however, the condition can then be managed more effectively with AFib medications.


Heart and Vascular Care

The cardiologists and cardiovascular surgeons at Main Line Health work together to improve the detection and prevention of heart disease with the latest treatment options.