Maze Procedure for Atrial Fibrillation

The maze procedure is used to treat atrial fibrillation, a heart rhythm abnormality.

In normal heart rhythm, the electrical impulses that make the heart muscle contract start in the SA node (“the pacemaker”) on the right atrium and move down to the AV node, which makes the atria contract, and then to the ventricles for contraction.

In atrial fibrillation, the impulse does not go from the SA node to the AV node evenly. Instead, it localizes in one region, causing the atrium to fibrillate instead of contracting evenly.

This can usually be treated with medications, but surgical management can be used in cases where medications have failed.

Maze Procedure Preoperative Details

Your surgeon will give specific instructions before the surgery, including risks such as bleeding, infection, or adverse reaction to anesthesia. Please be sure to contact your insurance company for coverage.

You will also meet with the anesthesiologist prior to the surgery to go over your medical history. Please do not eat after midnight the night before your surgery.

On the day of surgery, you will arrive at the hospital, register, and change into a hospital gown. A nurse will review your chart to make sure there are no problems.

The anesthesiologist will start an IV, and you will be taken to the operating room, where the surgeon will verify your name and procedure before any medication is given. Surgery will begin once you are under anesthesia.

Maze Procedure Operative Details

The surgeon will make a long incision in the breastbone and spread the ribcage apart to expose the heart.

Once the surgeon reaches the heart, you are put onto cardiopulmonary bypass, a device that pumps oxygenated blood throughout the body, bypassing the heart and lungs so the surgeon can operate on the heart.

The surgeon then makes multiple small incisions on the atria, disrupting the “bad” circuits that disturb the normal electrical impulse flow. These incisions are made in a precise manner to create a maze that allows only one correct path for an electrical impulse 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 your heart is restarted, the cardiopulmonary bypass is removed and the chest is closed using stitches or staples.

Maze Procedure Postoperative Details

After the maze procedure, you will be taken to the intensive care unit and monitored. Pain is likely, so you’ll be given pain medication appropriately. You will also have chest tubes to drain excess fluids and blood from the chest cavity after surgery.

You will be on a respirator to help you breathe until you are able to breathe on your own, and you will not be able to speak during this time. It’s important to keep the incision areas clean and dry.

The length of your hospital stay depends on how quickly you are able to recover and perform some physical activity. Please let your doctor know immediately if you experience fevers, severe pain, redness, swelling, warmth where the incisions were made, or drainage from the incisions.

Your surgeon will give specific instructions about recovery time.

Request an Appointment

To schedule an appointment with a maze procedure expert at UT Southwestern's facilities in Dallas or for more information about our services, request an appointment or call 214-645-8300.