Hybrid Maze

Combines advanced thoracoscopic surgical techniques to treat atrial fibrillation without a sternotomy. Four ports are placed on each side of the chest and tools are inserted through the ports. 

A hybrid maze procedure is a two-stage treatment for atrial fibrillation that combines surgical and catheter-based approaches to improve rhythm control when medications or ablations alone have proven ineffective. See below for a description of each stage. 

A video-assisted thoracoscopic (VATS) maze is a minimally invasive surgical ablation procedure. The surgeon uses radiofrequency to create precise scar lines on the surface of the heart to interrupt erratic electrical signals. By creating a maze lesion, the electricity is corraled and controlled, restoring sinus rhythm. Pulmonary vein isolation is key in this. The surgeon will also ligate the left atrial appendage (the stroke center of the heart) with an AtriClip (atricure.com), which eliminates the need for blood thinners postoperatively. 

This stage is typically completed 6-12 weeks after the heart tissue has healed from the VATS maze. This is done via femoral vein access with catheters and uses mapping guidance to address any leaks in electricity. This stage addresses any signals on the inside of the heart that may not have been reached during the first stage. We call this a "cath light" as it is mostly used for touch up and flutter ablation if needed. 

This hybrid approach address erratic signals both inside and outside of the heart. This approach has achieved higher success rates in the treatment of AFib versus surgery or ablation alone. This procedure avoids a full sternotomy with a minimally invasive approach. It provides a more complete lesion set leading to lower recurrence rates and reduced need for repeat procedures. It also allows for freedom from antiarrhythmics and anticoagulants and a better quality of life.