Back to Search
Start Over
When Is a Maze Procedure a Maze Procedure?
- Source :
- The Canadian journal of cardiology. 34(11)
- Publication Year :
- 2018
-
Abstract
- The initial surgical attempts to treat atrial fibrillation (AF) were isolation procedures designed to confine the arrhythmia to a specific area of the heart for relief of symptoms. The first surgical attempt to ablate AF was unsuccessful but was quickly followed by the Maze-I procedure on September 25, 1987. Because of several adverse sequelae of the Maze-I procedure, it was sequentially modified to the Maze-II and then Maze-III procedures. The Maze-IV procedure was introduced some 10 years later; these are the only 4 procedures that adhere to the concept of a maze pattern of lesions to ablate AF and leave both atria capable of being activated during normal sinus rhythm. The term maze procedure has become generic for virtually any operation designed to treat AF, but procedures that do not adhere to the concept of creating lesions of conduction block in the pattern of a maze are not maze procedures. These include, among others, the Wolf Mini-Maze, the Left-Sided Maze, and the 5-Box Maze, none of which are truly based on the maze-pattern concept. The cardinal feature of maze procedures that is necessary for both effectiveness and comparability to classical maze procedures includes lines of conduction block that preclude macro-reentry anywhere in either atrium while leaving both atria capable of activation by a sinus-generated impulse. Components essential to achieving this include appropriate lesions in both atria, the absence of gaps that allow electrical activity to bypass an intended line of block, and the absence of alternate pathways by which impulses can reach the intended maze exit.
- Subjects :
- medicine.medical_specialty
Cox maze procedure
medicine.medical_treatment
Isolation procedures
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Heart Conduction System
Internal medicine
Atrial Fibrillation
medicine
Humans
Minimally Invasive Surgical Procedures
030212 general & internal medicine
Heart Atria
Cardiac Surgical Procedures
Normal Sinus Rhythm
Atrium (architecture)
business.industry
Atrial fibrillation
medicine.disease
Both atria
Cardiology
Cardiology and Cardiovascular Medicine
business
psychological phenomena and processes
Subjects
Details
- ISSN :
- 19167075
- Volume :
- 34
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- The Canadian journal of cardiology
- Accession number :
- edsair.doi.dedup.....2f61586a86aeab54b3851bb0184abbad