For Faulty Heartbeat, Mini-Maze = Maxi-Results

The benefits—shorter hospital stay, quicker recovery

Rhythms of the Heart

In a normal heart, electrical impulses begin in the upper left area and follow an organized path to create steady heartbeats.

In atrial fibrillation, many areas (purple arrows) send out impulses that cause the heart to quiver (fibrillate) or beat irregularly.

Edward Diefenderfer of White Haven put his planned Ireland vacation on hold when his heart started skipping beats. “I felt like a car that wasn’t firing on all cylinders,” says the 64-year-old. “I had no energy or strength.”

The cause was atrial fibrillation, a condition that stemmed from Diefenderfer’s previous heart attack. It causes the heart’s top chambers (atria) to quiver and beat more frequently than the bottom chambers, raising the risk for blood clots and stroke. While medication helped Diefenderfer control his symptoms for more than two years, it eventually became ineffective. His cardiologist, Jeffrey Snyder, M.D., referred him to cardio-thoracic surgeon James Wu, M.D., at Lehigh Valley Hospital and Health Network.

“Because Edward is relatively young, has no major heart disease and was having intermittent yet severe symptoms,” Wu says, “he was a perfect candidate for the mini-Maze procedure.” Like the original Maze procedure, this new surgery cures an irregular heartbeat—but without the large incision in the chest and the heart-lung bypass machine.

With mini-Maze, two small incisions are made on each side of the chest between the ribs. “We insert a radiofrequency device that allows us to deliver energy to the heart,” Wu says. “The energy is used to create scars in a maze pattern around the atria, to redirect the heart’s electrical signals and correct the heartbeat.”

An alternative treatment, catheter-based intervention, is performed through a small incision in the groin. An energy-equipped catheter is moved up through an artery until it reaches the heart, where the same maze patterns are made.

Before these new options were available for atrial fibrillation, Maze procedure patients would be hospitalized for a week. Diefenderfer was home in three days. He began rehabilitation a month later, and today he faithfully walks on a treadmill for 30 minutes every day.

A mini-Maze procedure is pronounced a success when the patient has gone six months free of symptoms (including rapid heartbeat, weakness, fatigue, shortness of breath and low blood pressure). Such is the case for Diefenderfer. “I’m not taking any medications,” he says, “and I feel like my engine is back in tune.”

Want to Know More about other types of heart surgeries? Click here.

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