Atrial fibrillation (AFib) is the most common and frequent, irregular sinus heart rhythm ailment diagnosed today. In some cases, the standard treatment option for AFib is cardiac ablation. However, cardiac ablation can fail. Today, there is an alternative available for these types of failed ablation cases. The Cox-Maze Procedure is a minimally-invasive surgical procedure for long-standing and persistent atrial fibrillation. Treatment for atrial fibrillation is paramount due to the fact this type of “fast” heart rhythm can increase the risk of a stroke in individuals at a seven-time higher rate than those without the disorder.
This AFib condition is threatening because it can cause blood to pool in the heart chambers causing clumps of blood or blood clots to form and if given the chance to travel to the heart and into a small artery in the brain can lead to or cause a stroke. Non-treatment of AFib, which arises in sometimes brief, impermanent paroxysmal or long-lasting persistent and permanent episodes, can lead to congestive heart failure, heart attacks, fatigue, and mortality risks. Effective medical or surgical treatment of AFib returns patients back to normal sinus rhythm.
The Cox-Maze procedure uses alternative energy sources, such as radiofrequency and cryo energy (cryoablation) to provide treatment for AFib by disabling the heart cells causing the irregular heartbeat condition. Upper chambers in the heart develop rhythm in an uncoordinated fashion during AFib. During surgical treatment, minimal incisions are made in the atria or upper chambers of the heart to interrupt irregular electrical routes causing AFib, thus returning the heart back to regular status. The Maze surgery procedure works after the heart heals when scar tissue forms. Scar tissue cannot conduct electrical impulses so the scar tissue from the Cox-Maze procedure forms barriers around the incisions. This causes a maze effect keeping electrical impulses on proper course.
In addition, the Cox-Maze Procedure can be performed along with other cardiac procedures if needed, such as mitral valve surgery and coronary artery bypass grafting (CABG). The best way to understand the Maze Procedure is in its namesake, the procedure literally forms a new maze of electrical pathways for the heart to use in in its everyday function. Maze procedures are often recommended after medicine or interventional treatments are exhausted or ruled out.
Recovery from Mini Access Cox-Maze Procedure for Failed Ablation
Prior to surgery, the Maze Procedure patient may need an electrocardiogram (ECG or EKG), blood tests, urine tests, and a chest X-ray. Smokers must discontinue smoking at least two weeks prior to surgery because smoking can cause blood clotting and breathing problems. Anesthesia is given during the operation. After surgery, a short hospital stay may be required until the atrial tissue swelling reduces and the sinus node function, pacemaker of the heart, returns to optimal function. Following discharge from the hospital, recovery and resumption of normal energy levels should occur within four weeks’ time.
Dr. Erik Beyer is a board-certified cardiothoracic surgeon, specializing in minimally invasive valve surgery and atrial fibrillation surgery, mitral and aortic valve repair, aortic root reconstruction, aortic aneurysm, thoracic surgery, transcatheter aortic valve repair (TAVR), coronary revascularization and patient safety. Dr. Beyer’s Tenet Florida Physician Services offices are located in Fort Lauderdale and Delray Beach, FL. He is on-staff at Florida Medical Center, a campus of North Shore located in Fort Lauderdale.