A-Mazing treatment for Afib

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The following was taken from a DukMed pamphlet:

" A new treatment for recalcitrant atrial fibrillation uses microwave technology

to block the irregular electrical signals responsible for the heart arrhythmia.

Thoracoscopic Maze (or MicroMaze) is a minimally invasive variation of the

-Maze, developed by Duke surgeon , MD, around 1990 to treat Afib.

In the original Maze procedure, small precise cuts are made into the atrial

wall, creating a maze around the areas in which abnormal electrical signals are

traveling. Scar tissues created by these cuts permanently blocks the abnormal

paths and form a single maze-like route for the electrical impulse to travel

from the top to the bottom of the heart. But -Maze requires the surgeon to

open the sternum and place the patient on cardiopulmonary bypass so it was

usually performed in conjunction with another open heart procedure, such as

coronary artery bypass surgery (CABG) or valve replacement.

By contrast, MicroMaze is a video-assisted thoracoscopic surgery (VATS)

performed through six small incisions on the side of the chest. A flexible

microwave probe placed on the surface of the beating heart heats the desired

locations, creating lesions in the atrial wall without cutting. Scar tissue

forms around these lesions in the months following the procedure. During

MicroMaze, the surgeon can also staple off the left atrial appendage,

significantly reducing the risk of ischemic events, stroke or blood clots.

Appropriate candidates for thoracoscopic Maze include any adult with atrial

fibrillation and no prior history of chest surgery, especially those at high

risk of embolic events. Performed in conjunction with other cardiac procedures

(such as CABG or mitral valve replacement. MicroMaze adds only 15 or 20 minutes

to the surgery. Most patients are released the day after the two hour procedure

and can return to work within the week. About 70 percent of patients are cured

by MicroMaze.

Duke is one of only four US Medical Centers currently offering the procedure

which is fully FDA approved and Medicare reimbursed. Among the handful of

surgeons nationwide with expertise in the unusual technique is Sinan Simsir, MD,

who performed the worlds first six MicroMaze procedures at the University of

Massachusetts before coming to Duke this year. " {Because MicroMaze has only

been in use for about two years " , says Simsir, " long-term outcomes are not yet

available'. However, he adds, 'If my Dad had chronic Afib, I would recommend it

for him.' " Visit Duke University Health System online at

http://www.dukehealth.org/