Surgical lessons learned from the treatment of atrial fibrillation

In 1987, the MAZE procedure was introduced into clinical practice by Dr. James Cox. Prior procedures included AV node ablation and other procedures that had major limitations. The clinical success of the MAZE procedure was over 90% in most series. Adoptability was limited by its technical complexity. With the introduction of a variety of energy sources to replace the "cut and sew" lines of ablation without sacrificing clinical success, the procedure has been widely adopted in conjunction with other cardiac operations ("concomitant" Maze procedures). Surgical techniques for "stand alone" procedures continue to evolve as the technology to perform the procedure less invasively is developed.