Risks

The risks of atrial fibrillation ablation vary depending on whether you are undergoing a catheter ablation or open-heart surgery, which is less common. Risks include:

• Bleeding or infection at the surgical site or where your catheter was inserted
• Damage to your blood vessels
• Puncture of your heart
• Damage to your heart valves
• Damage to your heart's electrical system, which could worsen your arrhythmia and require a pacemaker to correct
• Blood clots in the legs or lungs (venous thromboembolism)
• Stroke or heart attack
• Narrowing of the veins that carry blood between your lungs and heart (pulmonary vein stenosis)
• Death in rare cases

Discuss the risks and benefits of atrial fibrillation ablation with your doctor to understand if it's right for you.

How you prepare

Your doctor will examine you and order several tests to evaluate your heart condition. He or she will discuss with you the risks and benefits of your atrial fibrillation ablation procedure. Let your doctor know about allergies or reactions you've had to medications. And tell him or her if you're pregnant or planning to become pregnant.

You'll need to stop eating and drinking the night before your procedure. If you take any medications, ask your doctor if you should continue taking them before your procedure. In some cases, you'll be instructed to stop taking medications to treat a heart arrhythmia several days before your procedure.

If you have an implanted heart device, such as a pacemaker or implantable cardioverter-defibrillator, talk to your doctor to see if you need to take any special precautions.

Overview

Maze is a surgical procedure used to treat atrial fibrillation. A doctor creates a pattern of scar tissue (the maze) in the upper chambers of the heart by applying heat or cold. Or, the doctor uses a scalpel to make several precise incisions. This method is more complex and takes longer.

Because scar tissue doesn't carry electricity, the maze interferes with stray electrical impulses that cause atrial fibrillation.

Why it's done

The maze procedure is done to correct atrial fibrillation and improve the quality of life of people with this condition.

The maze procedure is the preferred method of atrial fibrillation treatment if you also need another heart surgery, such as for coronary artery bypass or valve repair. In these cases, the maze procedure is done during open-heart surgery. It may also be the preferred treatment for people who don't respond to other treatments or are experiencing a recurrence of atrial fibrillation.

What you can expect

To be considered for the surgical maze procedure, your heart doctor will have you undergo several tests. If you are scheduled for surgery, your care team will talk with you about how to prepare and what to bring to the hospital.

During the procedure

For the surgical maze procedure, you will be put to sleep with general anesthesia and placed on a heart-lung bypass machine.

Then, your doctor will make an incision in your chest and access the upper chambers of your heart. He or she will use energy — such as heat, cold or laser — or a scalpel to create the pattern of lines. Scar tissue forms where the lines are created. This disrupts faulty electrical signals.

While you are on the bypass machine, your doctor may also do other needed cardiac surgeries, such as valve repair or pacemaker placement.

Some patients may be treated with a robot-assisted catheter ablation procedure called a mini-maze.

Results

Surgical maze procedures have a high success rate, with from 70% to 95% of people being free of atrial fibrillation long term after the procedure. Some people may still need medications to help control their irregular heart rhythm after the procedure. If your atrial fibrillation returns, you may need another catheter ablation or other treatment.

If you develop a slow heart rhythm after your maze procedure, your doctor may suggest you have a pacemaker implanted.