THE MAZE PROCEDURE FOR CURE OF ATRIAL FIBRILLATION

The earliest and simplest approach to the control of medically refractory atrial fibrillation was atrioventricular node ablation and pacemaker insertion. Although this approach addressed the issue of rate control, it did not correct the problems associated with the loss of atrial kick and continued susceptibility to thromboembolism. The subsequent development by Scheinman and associates22 of catheter-based technology to achieve atrioventricular node ablation rendered this approach less invasive but did not alter the aforementioned shortcomings. With these deficiencies in mind, a number of alternative surgical techniques have been designed by the authors and others in an attempt to correct the adverse consequences of this common dysrhythmia. In 1980, the authors reported the left atrial isolation procedure, which was capable of confining atrial fibrillation to the left atrium while restoring the remainder of the heart to sinus rhythm.24 The procedure was initially developed with the control of ectopic atrial tachycardias in mind; however, its beneficial effects in the Work was supported by NIH grants ROlHL32257 and