What to Expect After a Mini Maze Procedure

Patients, including our founder, Mellanie True Hills, have shared their experiences about what to expect after minimally invasive afib surgery. Below, you’ll find what they shared, including what to expect while in the hospital, problems you might experience, and follow-up with your doctors after the procedure.

In the Hospital

After surgery, you may be in the intensive care unit (ICU) anywhere from a few hours to a day or more and will be monitored very closely. Even after moving to a regular hospital room, expect to be hooked up to monitors. The nursing staff will monitor your heart rate and blood pressure to know how you are doing at all times. You may have other tests run as well to check your heart and lungs.

At your side, you may have a device that lets you self-administer pain medication. Some patients specifically mentioned using pain medication. Still, our founder recalls the hospital staff frequently asking her why she hadn’t used it. She had too much anesthesia and thus didn’t feel the pain but felt reassured, knowing the pain medication was there if needed.

To help you recover, you may be given a spirometer for breathing exercises to help keep fluid out of the lungs. Mellanie was still under intense anesthesia when they brought the spirometer, so she doesn’t remember being told how to use it. Knowing how to use the spirometer before your surgery could shorten your hospitalization and hasten your recovery.

Once you leave the ICU and settle into a regular hospital room, you’ll start gradually walking. When the nurse told Mellanie, “we’re going for a walk around the nurse’s station with a walker, and I’ll help you,” she wondered why she would need help. But, instead, she soon learned just how wobbly she was, primarily because of the anesthesia, which impacted her for a week.

After the procedure, you may go back on anticoagulants and possibly antiarrhythmic drugs for several months. But, again, the protocols vary from center to center, typically lasting about 1–3 months.

You’ll likely go home after 2–4 nights in the hospital. This is significantly shorter compared to a week or more in the hospital following an open-chest maze procedure. The recovery time is much faster, too, and the risks are significantly less as well.

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Mellanie True Hills
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Problems Experienced

While minimally invasive surgical ablation is not as invasive as open-heart surgery, it is still surgery involving anesthesia, pain, soreness, tubes, recovery time, and risks.

Most patients don’t experience any serious issues, though a few do. Here are some of the common things patients have told us that they experienced:

  • Chest tightness, soreness, pain, tenderness, and occasional swelling—many recommend getting some pain medication before the trip home.
  • Coughing or difficulty breathing at first, which can be resolved by breathing exercises with a spirometer to keep fluid out of the lungs.
  • Unusual heart rhythms—most were afib-free after surgery, though some experienced arrhythmias like slow or rapid heart rates or irregular heartbeats. It isn’t unusual for 30%-50% to experience skipped heartbeats or short afib episodes in the first three months after any heart procedure due to swelling and inflammation of atrial tissue. Just knowing to expect this can alleviate much of the anxiety associated with it.
  • Pain or irritation from drainage tubes were common complaints. After surgery, these tubes are placed in the chest to drain fluid from around the heart and lungs. It may be uncomfortable to have them removed if you’re not still under the effects of anesthesia.
  • Nausea or feeling hungover from the anesthesia.
  • Fluid retention—one patient went home from the hospital ten pounds heavier. The clothes worn to the hospital no longer fit several days later. It might be worth having loose, comfortable clothes to wear home and afterward for a week or two. This may not impact some patients.

Though this list could be a little scary and intimidating, most of these things are insignificant compared to the after-effects of open-heart surgery.

A small percentage of patients may also experience sensitivity to anesthesia. For example, the first night, Mellanie felt extraordinarily nauseated and hungover for a week. Even though the amount of anesthesia was carefully calculated based on weight and body size, she received too much but has since learned that she’s sensitive to anesthesia.

It’s also common for a small percentage of patients to require a pacemaker afterward. But, again, the rate varies from center to center and may reflect patient anatomy and surgeon experience and technique. In addition, patients who have had afib for a long time may have Sick Sinus Syndrome, which is when the heart’s natural pacemaker, the sinus node, no longer works properly.

Post-Surgery Follow Up

Expect to follow up with your doctor or surgeon—which one depends on where you had your surgery and whether it was out-of-town—about a week after surgery and again a few weeks later. Asking lots of questions in advance may help you make sure that the handoff from your surgeon to your cardiologist or primary care physician is as seamless as possible.

At your follow-up visit, you may have an EKG or other tests to see how your heart is doing and ensure that the afib is resolved. Expect to have EKGs at 3–6 month increments over the first year and annually after that.

In addition, you may be asked to wear an event monitor for a few weeks to record any abnormal heart events. You will likely do so at 3-6 month intervals over the first two years. If things look good after wearing the event monitor the first time, you may be able to stop your atrial fibrillation medications.

Getting Back to Normal

Most minimally invasive afib surgery patients seem to go back to walking and exercising within a few days, though regaining energy and muscle mass takes time. Most are back at work within a few days to two weeks after surgery. One went back to work just 2 days after leaving the hospital but realized that was much too soon and hindered her recovery.

The incisions heal over time and leave only tiny scars. That is a very small price to pay for the peace of mind that comes from a surgery that can stop your afib and eliminate your blood clot and stroke risk.

Many mini maze patients, especially those with paroxysmal atrial fibrillation, are still afib-free many years after surgery. Early on, Mellanie had one minor incident of tachycardia created by her dentist when he gave her a shot containing epinephrine. Fortunately, it resolved quickly, and she is still afib-free from her mini maze in 2005.

One mini maze patient mentioned that he has a slower heart response to a “load,” such as walking upstairs, but everything is fine when the heart catches up.

The great news is that you don’t have to endure a decade or two of atrial fibrillation while waiting for a cure.

And if you are younger than most atrial fibrillation patients, minimally invasive afib surgery may be easier on you and your body. This is because incisions are becoming smaller and even less invasive as the procedure evolves.

If you’re a female interested in the mini maze procedure, see For Women Having Mini Maze Surgery.

Or learn more about Reclaiming Your Life after the mini maze procedure.