The Maze procedure is a surgical treatment for atrial fibrillation (AFib) that creates a pattern of scar lines in the atria to redirect electrical signals and restore normal heart rhythm. Originally performed using a "cut-and-sew" technique, modern Maze procedures use radiofrequency energy or cryoablation to create the lesion pattern. The full Cox-Maze IV procedure has a 90-95% success rate for eliminating AFib at experienced centers.
The Maze procedure is most commonly performed concomitantly with other cardiac surgery — for example, during mitral valve repair in a patient who also has AFib. Standalone surgical Maze is also an option for patients who have failed catheter ablation. The 2020 ACC/AHA guidelines provide a Class IIa recommendation for surgical ablation during concomitant cardiac surgery. Left atrial appendage closure is typically performed simultaneously to reduce stroke risk.
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