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J Thorac Cardiovasc Surg 2006;132:1253-1255
© 2006 The American Association for Thoracic Surgery

Editorial

How do we spell maze? A dialogue concerning definitions and goals

Inova Heart and Vascular Institute, Falls Church, Va.

Received for publication July 7, 2006; accepted for publication August 30, 2006.

^_* Address for reprints: Niv Ad, MD, Director of Cardiac Surgery Research, Inova Heart and Vascular Institute, 3300 Gallows Rd, Falls Church, VA 22042. (Email: niv.ad@inova.com).

The first 300 words of the full text of this article appear below.

In this issue of the Journal, Ballaux and colleagues¹ from The Netherlands present their experience with more than 200 patients who underwent the cut-and-sew maze III procedure. The study was designed to assess the long-term results of the maze III procedure.

In recent years we have witnessed a significant increase in the number of surgical procedures performed to ablate atrial fibrillation. As a result, there is a flux of publications reporting the results of such procedures. However, most of the studies do not address the true impact of the procedure on patients’ outcome and well-being. The literature is also lacking information regarding the correlation between the success in ablating atrial fibrillation and a favorable long-term outcome.

The authors of this article are to be congratulated for their excellent results in a large series of patients. Nevertheless, the current report brings to attention the difficulties and challenges that we currently experience when assessing the results of surgical treatment for atrial fibrillation and its impact on patient outcomes.

Although atrial fibrillation is considered by many to be an innocuous arrhythmia, it may be associated with significant mortality and morbidity. The main focus is obviously the risk of thromboembolic events and strokes; however, heart failure may develop in a significant number of patients. There is also growing evidence that atrial fibrillation can cause patients discomfort and anxiety with a negative impact on quality of life.² Therefore, the nonpharmacologic treatment to be offered to patients at risk for a complicated course is reasonable.³

Definition of the Surgical Treatment for Atrial Fibrillation

The first maze procedure was performed on September 25, 1987, only after extensive laboratory work. The maze I procedure,⁴ the original surgical technique for the treatment of atrial fibrillation, was modified to become the maze II procedure and later the maze III procedure because of late chronotropic problems with the . . . [Full Text of this Article]

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