What is the Cox-Maze procedure?
(also known as Maze Procedure)

The Cox-Maze procedure (also known as Maze procedure) is a surgical treatment for atrial fibrillation or atrial flutter.

What is Atrial fibrillation

Atrial fibrillation (AF or AFib) is the most common irregular heart rhythm in the United States. Atrial fibrillation is an abnormal heart rhythm originating in the atria (top chambers of the heart). Instead of the impulse traveling in an orderly fashion through the heart, many impulses begin simultaneously and spread through the atria, causing a rapid and disorganized heartbeat. At one time, atrial fibrillation was thought to be a harmless annoyance. However, atrial fibrillation is now recognized as a dangerous condition. Atrial fibrillation doubles the risk of death. It also increases the risk of stroke five to seven times compared to a person without atrial fibrillation. In addition, atrial fibrillation may cause congestive heart failure and uncomfortable symptoms related to a rapid heart rate. Click here to learn more about atrial fibrillation (afib).

During Surgery

Certain patients with isolated atrial fibrillation, especially continuous atrial fibrillation and/or enlarged atria, are candidates for the Maze procedure. The Maze procedure, developed by Dr. Jim Cox, can treat the atrial fibrillation and restore the atria to a more normal size.

During the Maze procedure, a series of precise incisions are made in the right and left atria to interrupt the conduction of abnormal impulses. This allows sinus impulses to travel to the atrioventricular node (AV node) as they normally should following Maze procedure.

A series of precise incisions are made in the right and left atria to interrupt the conduction of abnormal impulses. This allows sinus impulses to travel to the atrioventricular node (AV node) as they normally should.

The Maze procedure has been very successful with a 98% success rate in "lone atrial fibrillation" patients and a 90% success rate overall. Post – Maze procedure freedom from stroke has been over 99%.

Click here to learn more about the maze and modified maze procedures - including surgery and recovery.

Successful Results

Surgeons began performing the Maze procedure at the Cleveland Clinic Foundation in 1991. New surgical techniques (including minimally invasive surgery and modified Maze procedures) allow surgeons to successfully treat this common but potentially life-threatening condition, providing:

• Long-term freedom from atrial fibrillation
• Decreased symptoms following the Maze procedure
• Greatly reduced embolic events (such as blood clots or stroke)
• Decreased atrial (top chamber of the heart) size in those with enlarged atria pre-surgery, particularly those who undergo Maze procedure with mitral valve repair procedure.

Click here to learn more about surgical treatment for atrial fibrillation

Click here to see our surgical outcomes

To be evaluated for surgical treatment of atrial fibrillation:

• Click here to request an appointment online, or you may also call the Heart Center Resource and Information Center Nurse at 216/445-9288 or toll-free 866/289-6911.
• You may also use our eClevelandClinic second opinion consultation using the internet.

For questions or more information, you may contact us by email, using the Contact Us Form. Please state "Center for Atrial Fibrillation" in the Question or Comment Section. You may also call the Heart Center Resource and Information Center Nurse at 216/445-9288 or toll-free 866/289-6911, or chat online with a nurse by clicking on the button on Heart and Vascular Institute web pages. Webmail, phone calls, and chats are answered between 8:30 am to 4:00 pm on regular business days.

If you are already treated at the Cleveland Clinic Foundation for atrial fibrillation, talk to your cardiologist about whether surgery is an option for you.

Click here to find a surgeon who performs surgery to treat atrial fibrillation, such as the Maze Procedure

Center for Atrial Fibrillation home page