Atrial Fibrillation Ablation

Surgical atrial fibrillation ablation, often called a Maze procedure, is performed to treat atrial fibrillation, the most common type of heart arrhythmia.

At St. Joseph's Heart & Vascular Institute, we have one of the most experienced cardiac surgery teams in the nation. Patients undergoing surgery for atrial fibrillation can feel confident knowing that our team performs more cardiovascular procedures than any other hospital in California.

What is Atrial Fibrillation Ablation?

Atrial fibrillation ablation, also called a MAZE procedure, is a surgical procedure done to treat atrial fibrillation (AFib), a dangerous heart condition in which the upper chambers of the heart (the atria) beat abnormally fast.

AFib Ablation may be performed in an open chest surgery or in a minimally invasive procedure, sometimes called a Mini MAZE. In these procedures the source of the heart arrhythmia is mapped in an electrophysiology study, localized, and then ablated or destroyed.

What Happens During Surgical Atrial Fibrillation Ablation

Open surgical atrial fibrillation ablation is a type of open heart surgery and often requires a heart-lung bypass. A minimally invasive procedure is also available. In both procedures:

  • In an electrophysiology study (EPS) the surgeon uses instruments to identify the faulty electrical sites in your heart causing it to beat irregularly and too fast.
  • Then an instrument with a heat source is used to create precise scars, or ablations, on those spots. These scars will block the abnormal electrical impulses which cause AFib and can return your heart to a normal rhythm.
  • The surgeon may also create the necessary ablations that can block the abnormal electrical impulses causing your AFib.
  • Additionally, many surgeons remove or close off a small cul-de-sac-shaped pouch on the heart (the left atrial appendage) believed to be the primary site where stroke-causing blood clots form during AFib.

Minimally Invasive Atrial Fibrillation Ablation

For people who suffer from atrial fibrillation (AFib), but are otherwise fairly healthy, a minimally invasive atrial fibrillation ablation (or Mini Maze) may be an option. It is similar to the concomitant ablation (described above), except that the surgeon reaches the heart through small incisions on each side of the chest and does not require that the heart be stopped. In the minimally invasive MAZE ablation:

  • The surgeon accesses the heart by making three small incisions between the ribs, through which a tiny camera and video-guided instruments are inserted.
  • The surgeon uses an energy source to make precise scars, or ablations, on the heart to block the irregular electrical impulses that cause AFib and removes or closes off the left atrial appendage where stroke-causing blood clots often form (as in the open chest procedure).
  • Not having to open up the whole chest makes recovery much easier and reduces the average hospital stay to around four days.

At St. Joseph's Heart & Vascular Institute, we offer other minimally invasive treatment options for atrial fibrillation. Learn more about robot-assisted catheter ablation.

Am I a Candidate for Atrial Fibrillation Ablation?

You may wish to discuss atrial fibrillation ablation with your doctor if:

  • You have AFib symptoms that are severely interfering with your quality of life
  • Your medications are not working or you cannot tolerate their side effects
  • You are at risk for forming clots and having a stroke
  • You and your doctor may want to consider surgical atrial fibrillation ablation if you have AFib and need open heart surgery for another reason such as bypass surgery or a valve repair or replacement.