Ask An Expert: CryoMAZE

Content provided by the Faculty of the Harvard Medical School

Ask An Expert: CryoMAZE

Question:

What exactly is the CryoMAZE procedure?

Answer:

The MAZE procedure is a relatively new approach to the treatment of atrial fibrillation. In people with atrial fibrillation, the heart's electrical impulses move in repetitive circular patterns, triggering heart muscle cells in the upper heart chambers (atria) to contract in a very chaotic way.

In the original MAZE procedure, heart surgeons made very tiny, strategically placed cuts in the upper chambers of the heart. The cuts in the surface of the heart prevent the repetitive, rapid circling of electrical impulses that cause the irregular heart rhythm.

When the MAZE procedure is successful:

The heart muscle cells in the atria contract as a well-functioning unit, and
The electrical impulses move along the proper path from the upper heart chambers to the lower heart chambers (ventricles).

CryoMAZE uses a freezing technology to create the "cuts" in the heart to block the abnormal circular electrical waves, instead of actual cuts with a blade. Just as in the original MAZE procedure, the areas of the heart that need electrical blocks are carefully mapped by the heart specialist and the duration of freezing is accurately timed.

Another technique used to create electrical blocks is called "radiofrequency catheter ablation." Instead of surgical cuts or freezing, this technique uses high-intensity radio waves directed at appropriate spots in the heart to block the electrical impulses.

The MAZE, CryoMAZE and radioablation procedures may be considered to treat atrial fibrillation when drugs are not successful or the drugs have caused too many side effects.

Howard LeWine, M.D., is chief editor of Internet Publishing at Harvard Health Publications. He is recognized as an outstanding clinician and teacher and is a recipient of the Internal Medicine Teacher of the Year award at Brigham and Women's Hospital. Dr. LeWine continues to practice Internal Medicine; most recently he became a hospitalist after practicing primary care for over 20 years.

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Last updated:	January 24, 2007

Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.

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