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Considering Mini-Maze Surgery for A-Fib? It May Come Up Short for You
About procedures for Atrial Fibrillations: A Mini-Maze is performed thru incisions in the chest with ablations on the outside of the heart; Catheter Ablation is performed by feeding a catheter up an artery to the heart with ablations made inside the heart.
A Mini-Maze surgery for A-Fib, like a catheter ablation, isolates the Pulmonary Veins (PVs). But that’s all. In Mini-Maze surgery, there’s no mapping to find and track down the locations of other electrical A-Fib signals.
Your A-Fib triggers may be coming from other parts of your heart, such as the right atrium, the left atrial appendage (LAA) and the coronary sinus (CS). When this happens, a second procedure is needed. But not a second Mini-Maze. A catheter ablation is needed to isolate these triggers.
Typical Mini-Maze incisions for surgical ablation of Atrial Fibrillation.
Why not Choose a Catheter Ablation Instead? By choosing a catheter ablation procedure in the first place, a highly-skilled Electrophysiologist (EP) uses sophisticated computerized mapping tools to test, track down and then ablate ALL the A-Fib trigger locations, not just the Pulmonary Veins.
A-Fib Recurrence: Recent studies have determined that Atrial Fibrillation can relapse after a year or more of being A-Fib free (for me it was 21-years, called ‘Very Late Recurrence’). This recurrence is not due to PV disconnection, but due to non-PV triggers. For more about recurrence see: After Two Years A-Fib Free, What Causes ‘Very Late Recurrence’ in Post-Ablation Patients?
If your A-Fib returns after mini-maze surgery: you will need a catheter ablation to map, track and then ablate these non-PVC A-Fib signals. (They also check your previously ablated Pulmonary Veins (PVs) for any gaps in the scars that may be allowing A-Fib signals through.)
If your A-Fib returns after a catheter ablation: a “touch-up” ablation can isolate of locations of these Non-PV signals such as the left atrial posterior wall, superior vena cava (SVC), left atrial appendage (LAA), lateral Right Atrium and the coronary sinus (CS). A “touch-up” ablation is often a shorter procedure than the first ablation.
Mini-Maze or Catheter Ablation? Why not reduce your chance of an A-Fib relapse a year or years down the road? A catheter ablation by an experienced Electrophysiologist (EP) includes mapping and ablating the Pulmonary Veins (PVs) AND all non-PV signals as well, in the first procedure. A catheter ablation by an expert EP can offer you this.
To learn more read Finding the Right Doctor for You and Your A-Fib and A-Fib Treatment Options.
Where can Non-PV A-Fib triggers be found? Right Atrial Appendage, Superior Vena Cava, Crista Terminalis, Tricuspid Valve Annulus, Eustachian Ridge, Fossa Vallis, Septum, Posterior Wall of Left Atrium, Mitral Annulus, and Epicardial Coronary Sinus, to name a few.
