Atrial fibrillation (Afib) is one of the most common heart rhythm disorders, affecting millions worldwide. It occurs when the upper chambers of the heart (atria) beat irregularly and out of sync with the lower chambers (ventricles), leading to symptoms like palpitations, fatigue, dizziness, and an increased risk of stroke.
In such cases, a surgical intervention known as the Maze procedure can offer long-term relief and improved heart function. Dr Upendra Bhalerao, Consultant Cardiothoracic and Transplant Surgeon, Jaslok Hospital and Research Centre, Mumbai, explains how this procedure works, who it's best suited for, and why it is considered the gold standard for treating Afib when other methods fail.
Also Read: How To Recognise Heart Palpitations Caused By A Heart Attack
What Is A Maze Procedure?
A Maze procedure is a type of heart surgery, also known as surgical ablation, used to treat Atrial Fibrillation (AFib), a common heart rhythm disorder.
According to Bhalerao, the Cox-Maze III procedure has become the gold standard surgical procedure for the treatment of Atrial fibrillation.
A 2024 study reviewed and analysed data from nine randomised controlled trials involving 663 patients and found that adding the Cox-Maze procedure significantly improved the chances of restoring and maintaining normal heart rhythm at discharge. Importantly, it did not increase the risk of death, stroke, pacemaker need, or blood clots.
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What Is Atrial Fibrillation (Afib)?
Dr Bhalerao describes Atrial fibrillation (Afib) as a common heart rhythm disorder where the upper chambers of the heart (atria) beat irregularly and out of synchrony with the lower chambers (ventricles).
"This rapid, irregular, uncoordinated electrical activity in the atria can lead to a rapid and irregular heartbeat, causing:
- Palpitations, causing patient discomfort and anxiety;
- Loss of synchronous contraction of heart chambers compromising cardiac haemodynamics and resulting in ventricular dysfunction, i.e., decreased pumping capacity.
- Stasis of blood flow in the left atrium, leading to increased risk for thromboembolism and stroke.
Who Needs A Maze Procedure?
The Maze procedure is designed to correct the three major complications of atrial fibrillation (Afib): irregular heart rhythms, reduced heart function, and increased risk of stroke due to blood clots. It is typically recommended for patients with:
- Persistent or long-standing atrial fibrillation
- Symptoms that do not respond to medication
- Atrial fibrillation diagnosed during planned cardiac surgery
- Cases where catheter ablation has failed
Are There Risks?
The Maze procedure, a surgical treatment for AFib, carries risks, though they are generally considered low.
Potential complications include bleeding, blood clots, stroke, infection, and the need for a permanent pacemaker.
While rare, complications like kidney failure and other abnormal heart rhythms can also occur.
Conclusion
The Maze procedure can be great for people struggling with atrial fibrillation, especially when medications or other treatments haven’t worked. It helps restore a steady heartbeat, improves how well the heart functions, and lowers the risk of stroke. Like any surgery, there are risks, but for many, the benefits far outweigh them.