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Maze Procedure Risks

Complications from surgical ablation maze procedures have generally been less than 1%.

In the early days, some risks were related to the surgical ablation energy source. With the earliest devices, surgeons estimated ablation times, which varied from patient to patient due to differences in heart wall thickness and thus led to some early injuries.1 For example, perforation of the esophagus occurred in about 1% of patients where unipolar radiofrequency (RF) energy was used.2 Safer bipolar radiofrequency energy sources now measure conductivity and determine when conduction block, called transmurality, is achieved.

Other reported complications include fluid retention and cardiac arrhythmia the first few weeks after surgery, but those usually subside as the heart and body heal. In addition, some patients have needed a permanent pacemaker due to injury in surgery or because their atrial fibrillation masked problems with the natural pacemaker. A review of the research finds that percentage may vary by energy source and by surgeon experience. In a high-intensity focused ultrasound (HIFU) study, 8% of patients needed a pacemaker,3 and in a cryoablation study, 19% of patients did.4

Finally, for those patients having arrested-heart maze surgery, there may be risks associated with being on the heart-lung machine.

If you're considering a surgical ablation maze procedure to cure atrial fibrillation and other heart issues, see Are You a Candidate for a Maze Procedure, What to Expect During a Maze Procedure, and What to Expect After a Maze Procedure.

1 Damiano, Ralph J., Jr., MD, "Alternative energy sources for atrial ablation: judging the new technology"<http://ats.ctsnetjournals.org/cgi/content/full/75/2/329>, The Annals of Thoracic Surgery, 2003;75:329-330.

2 Doll N, Borger, et al, "Esophageal perforation during left atrial radiofrequency ablation: Is the risk too high?" <http://jtcs.ctsnetjournals.org/cgi/content/abstract/125/4/836>, Journal of Thoracic and Cardiovascular Surgery, 2003 04 (Vol. 125, Issue 4).

3 Ninet, Jean, MD, et al, "Surgical ablation of atrial fibrillation with off-pump, epicardial, high-intensity focused ultrasound: Results of a multicenter trial" <http://jtcs.ctsnetjournals.org/cgi/content/abstract/130/3/803>, Journal of Thoracic and Cardiovascular Surgery, 2005;130:803.

4 Mack, Charles A., MD, et al, "Surgical Treatment of Atrial Fibrillation Using Argon-Based Cryoablation During Concomitant Cardiac Procedures" <http://www.circ.ahajournals.org/cgi/content/abstract/112/9_suppl/I-1>, Circulation, 2005;112:I-1 – I-6.

Last Modified 6/3/2009

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