The Maze procedure is a type of heart surgery used to treat atrial fibrillation.

The heart has four chambers. There are two upper chambers called atria and two lower chambers called ventricles. Normally, a specialized group of cells called the sinoatrial (SA) node in the upper right chamber of your heart, or the right atrium, provide the signal to start your heartbeat. With atrial fibrillation, the signal to start the heartbeat doesn’t begin in the sinoatrial node the way it should. Instead, the signal begins somewhere else in the atria. This causes the atria to quiver or “fibrillate.” The atria can’t contract normally to move blood to the ventricles. The disorganized signal spreads to the ventricles, causing them to contract irregularly and sometimes more quickly than they normally would. The contraction of the atria and the ventricles is no longer coordinated, and the ventricles may not be able to pump enough blood to the body.

In a traditional Maze procedure, the surgeon makes a number of small cuts in the atrium and then sews them back together. The heart’s electrical signal is not able to cross these cuts. The cut area now stops conducting the abnormal signals that caused the atrial fibrillation. The heart rhythm can therefore return to normal, and the heart can stop fibrillating. Traditionally, the Maze procedure is done as part of an open-heart surgery assisted with a heart-lung machine (cardiopulmonary bypass).

Instead of making cuts, doctors can use radiofrequency energy or freeze the tissue to disrupt the abnormal signals. These methods may allow the surgeon to use smaller incisions than would be necessary for traditional open-heart surgery. Sometimes the surgeon inserts a camera and small surgical instruments to perform the surgery.

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