Your heart relies on electrical impulses in order to sustain a regular beat. The impulses trigger contractions in the left and right atria. As the atria contract, the electrical signal travels down toward the left and right ventricles, causing them to contract. That process allows blood to flow from your heart to the rest of your body. If your heart experiences atrial fibrillation (a type of arrhythmia), the rate of contractions that occur within the atria accelerates and becomes disorganized.
A normal heart rate is between 60 and 100 beats per minute. Atrial fibrillation can cause it to beat up to 600 times per minute. As a result, you may feel dizzy, faint, or have difficult catching your breath. The maze procedure is used to treat and eliminate this type of arrhythmia. A surgeon will carefully create scar tissue that directs your heart's electrical impulses.
In this article, we'll explain how the maze procedure is performed. There are risks involved, which is why the operation is typically performed only after other forms of treatment have been considered.
How It Is Performed
Once the surgeon gains access to the site, he will make several small incisions into the left and right atria. Then, he will sew up the incisions in order to prevent blood from escaping. The purpose of making the incisions is to create scar tissue. The scarring disrupts the route traveled by the electrical impulses. Once the atria are sewn back together, the impulses cannot traverse the incision lines. They are guided by the scars as if traveling through a maze. The result is that the patient's left and right atria are unable to fibrillate as they did prior to the operation. A regular heartbeat is restored.
Traditionally, surgeons have waited to perform the maze procedure until another open heart surgery procedure is scheduled. This is because the risks are considered to be significant. That said, new technologies are making it possible to perform the surgery in less time and with less invasive techniques.
Potential Risks Of The Procedure
Any type of surgery performed on the heart muscle carries risks. It can result in excess bleeding, myocardial infarction, stroke, or even a new arrhythmia. It can also potentially create the need for a pacemaker. This is one of the reasons many surgeons will recommend against the maze procedure unless the patient is already undergoing some other form of heart surgery (for example, mitral valve repair). While minimally invasive techniques are being used with more regularity, nine out of ten operations are still done in conjunction with other procedures.
Back when this operation was first being performed by surgeons, its success rate in eliminating atrial fibrillation was lower than it is today. Better technology has helped surgeons perform it more accurately and with better effect. Today, over 90% of patients who undergo the maze procedure regain a normal heartbeat.
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