Modification of the maze procedure for atrial flutter and atrial fibrillation. I. Rationale and surgical results

James L. Cox, John P. Boineau, Richard B. Schuessler, Robert D.B. Jaquiss, Demetrios G. Lappas

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310 Scopus citations


The original maze procedure that was described for the treatment of patients with atrial fibrillation was followed by an unacceptable incidence of two problems: (1) the frequent inability to generate an appropriate sinus tachycardia in response to maximal exercise and (2) occasional left atrial dysfunction. In an effort to overcome these problems, we modified the original technique (maze I) twice. The results of these modifications culminated in the maze III procedure, which is associated with a higher incidence of postoperative sinus rhythm, improved long-term sinus node function, fewer pacemaker requirements, less arrhythmia recurrence, and improved long-term atrial transport function. In addition, the maze III procedure is technically less demanding than either the maze I or maze II procedure. Therefore, the maze III procedure is now the technique of choice for the management of medically refractory atrial fibrillation. (J T HORAC C ARDIOVASC S URG 1995;110:473-84).

Original languageEnglish (US)
Pages (from-to)473-484
Number of pages12
JournalThe Journal of Thoracic and Cardiovascular Surgery
Issue number2
Publication statusPublished - Jan 1 1995


ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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