Occasionally, heart surgery may prove to be the best option for correcting arrhythmia, including atrial fibrillation.
The standard treatment is one of three variations of the Maze procedure.
This is the traditional method. Incisions are made in the atria (the top chambers) to create lesions that will interrupt the electrical signals that are causing the heart to beat irregularly. The left atrial appendage may be closed (a bit of extra tissue in the left side of the heart) to prevent blood clots from forming and causing a stroke. This procedure is usually performed in concert with other heart surgery since it involves opening up the chest and exposing the heart.
A variation of the traditional procedure, radiofrequency, cryothermy, microwaves, laser or ultrasound energies may be used to create the lesions, rather than incisions.
One of the newest alternatives to the Cox-Maze procedure is the minimally invasive Mini-Maze. Multiple, small incisions are made on each side of the chest, allowing surgeons to access the heart without having to perform open heart surgery. The surgeon places a special clamp-like tool on the left atrium, then performs ablation on the tissue between the jaws of the clamp, similar to traditional ablation. Mini-Maze is for patients who otherwise do not need open heart surgery, yet need to have atrial fibrillation episodes either eliminated or significantly reduced. Patients who have not benefited from or are not a candidate for catheter ablation may benefit from this surgical procedure.