News | February 13, 2008

New Hybrid Maze Technique Treats AFib Patients

February 14, 2008 - A new approach called Hybrid Maze combines techniques from two existing procedures to offer patients a minimally invasive treatment for atrial fibrillation.

Pioneered by Richard Lee, M.D., surgical director of Northwestern Memorial’s Center for Atrial Fibrillation, at Northwestern Memorial's Bluhm Cardiovascular Institute, the Hybrid Maze is a minimally invasive procedure that allows faster recovery, shorter length of hospital stay, lower infection rates and less trauma than traditional cardiac surgery.

Dr. Lee, together with Jeffrey J. Goldberger, M.D., director of Cardiac Electrophysiology and medical director of the Center for Atrial Fibrillation, has pioneered a minimally invasive Hybrid Maze procedure, which is done in two stages.

During Stage I of the Hybrid Maze, small incisions are made on the sides of the chest to access and place scar lines around the pulmonary veins. A tiny camera is inserted through one of the small incisions, which gives the cardiac surgeon a clear view of the veins and eliminates the need for the large incision in the traditional Maze procedure. The heart is beating during the procedure, as opposed to the traditional Maze where the heart would be on bypass. The scar lines, made via an energy source such as radiofrequency, cryo, laser, ultrasound and microwave, isolate abnormal electrical signals that cause atrial fibrillation and re-route the path of the electrical signals. After Stage I, the patient returns home and is monitored for approximately one month to see if the atrial fibrillation returns. Stage I can be up to 90 percent effective for certain types of atrial fibrillation. Patients with other types of atrial fibrillation may require Stage II.

For Stage II, patients undergo catheter ablation, which is a non-surgical and minimally invasive treatment that involves inserting several catheters into the heart and locating the abnormal electrical signals causing the atrial fibrillation. Once found, the pathway is destroyed with energy sources similar to those used in Stage I of the Hybrid Maze. Stage II targets areas of the heart that cannot be reached from the outside of the heart.

"It is through the strength of each procedure and a multidisciplinary team of outstanding clinicians that we offer a two-tiered approach to our patients," states Dr. Goldberger. "The electrophysiologists and cardiac surgeons at the Bluhm Cardiovascular Institute spend time getting to know each patient and understand the specific characteristics of their atrial fibrillation."

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