Maze Procedure

Is the maze procedure better thanablation for atrial fib??  Which one is minimum?  I thank you!

[StephPT]

An interesting question, and one i don't know the answer to.  What i think is important to consider is the complexity of the procedures.  the MAZE procedure is an open-heart procedure that requires the heart-lung bypass machine, while an ablation is "minimally invasive" (I was awake and complaining through mine!) with fewer complications.  The MAZE works by cutting the atrium of the heart and then sewing it back together...the incisions create road-blocks in the heart that encourage the electrical pathway to follow the normal course, rather than the A-fib course.  An ablation is a "burning" of the tissue of the heart with a laser to accomplish essentially the same thing.

One website i checked claims the MAZE is effective in 80-100% of cases.  Ablation rates can be lower than that, but finding someone who does A LOT of them can improve your chances.  When i was given the choice, i chose the ablation without blinking.  I would only use the MAZE as a last resort...just my opinion.

Hope this helps.

steph

[Bromley]

Hi. Everything I have ever read says PVI is the way to go.  From what I read, much more effective with fewer complications than MAZE.  Of course, only your doctor can tell you what is best for you...

[Elinka]

What is the PVI you wrote about?  Please respond-thanks!!!!!

[StephPT]

PVI stands for "pulmonary vein isolation"...it is the type of ablation that is done specifically for A-fib...MOST (but not all) A-fib is thought to originate from around the pulmonary veins in the left atrium of the heart.  The laser "burns" a circle around each vein to stop any abnormal pathway that might be causing the A-fib.

steph

[Elinka]

HI,

Did you have this done Steph?  If so was it successful?  how long were you in the hospital?  Many thanks!
Elinka

[StephPT]

yes, i had this done in a modified form (they only did two of the four pulmonary veins) for my swallowing induced tachycardia that presented very much like a vagally-mediated A-fib (caused by the vagus nerve).  I was in the hospital for 3 days...admitted the day before for testing and observation, next day procedure, and the third day for TEE and d/c.  Every facility does things differently, though...it depends on the length and complexity of the procedure.  I think this place admits the day before because people are traveling from all over the WORLD to see this guy (Dr. Warren "Sonny" Jackman at University of Oklahoma...he takes very unusual cases and those that others have failed at...i had two ablations at home that were unsuccessful) and they like to make sure you are there and your labs are ok before they get started (as you can't just "reschedule"...)

Hope that helps.  Yes, after 4 attempts (had to go to OK twice...i was a really rare case), I am fixed.  thank goodness!

steph

[Elinka]

I am considering the albation at Cleveland Heart Clinic where they are now reviewing my medical records!  I hear it's the best place to go-it is about 7 hrs. from my home here in New York State!  I thank you for all your help!

[StephPT]

Cleveland IS a great clinic.  My local EP recommended Michigan and Oklahoma, and the guy i mentioned above is doing something a bit different with the A-fib ablations and PVI's to include nerve plexus ablations for the vagally mediated type, so i really felt as though i made the right decision.  I know all about traveling!!  I'm in Pennsylvania, so it was quite a hike to Oklahoma, but well worth it.

Good luck!!

steph