MAZE Procedure Archive Questions

Below are Dr. Gammie’s answers to MAZE Procedure questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.



Now displaying records 1 to 15 of 25.

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Q : 1 09/16/2009	My wife has had three pulmonary vein ablations. The pulmonary veins are isolated according to the surgeon, but she is still experiencing AF. Do you know if this new procedure could possibly be applicable in her case. I am also trying to find out if this procedure is available in Canada. Yes, there is a possibility that the CryoMaze procedure may be able to cure your wife's atrial fibrillation. However, this will depend on several factors including how long she has had atrial fibrillation and if it is persistent or paroxysmal. The longer she has had atrial fibrillation (especially if it is persistent), the more difficult it will be to convert her back to a normal (sinus) rhythm. Unfortunately, I am not familiar with any surgeons who perform this procedure in Canada. If you are interested in your wife being evaluated here for this procedure, please do not hesitate to call me. My name is Mary- I'm Dr. Gammie's physician assistant. I can be reached at 410-328-5842.
Q : 2 09/10/2009	My husband's doctor wants him to have this procedure. He has an enlarged chamber, could this also be corrected with CryoMaze? Correcting atrial fibrillation with the Maze surgery MAY help to decrease the size of your husband's left atrium. It will depend on how long he has had atrial fibrillation, how large his atrium measures and if he has persistent or paroxysmal atrial fibrillation. The larger the atrium is, and the longer he has been in atrial fibrillation (especially if it has been persistent), the less likely it will be to decrease the size of his atrium since the atrium may have lost some of its elasticity as a result of the chronic nature of the atrial fibrillation. Mary- Dr. Gammie's physician assistant
Q : 3 03/14/2009	Is there an age that would be considered to be "too young" to have atrial fibrillation? A-fib can occur at any age, but is more commonly seen in the elderly population.
Q : 4 02/01/2009	I am a 48-year-old healthy female. I have been dealing with A-fib knowingly for about four years. It was intermittent in the beginning but as of late it occurs a couple times a week. More so, it seems, when my hormones are in high gear (heavy perimenopause symptoms). I do not take medication other than an aspirin a day. I am put off by the severe side effects of the medications offered. I am fearful of the ablation method. The a-fib has become bothersome for me. I was/am a runner and it interferes with that. I practice yoga and both are important to me. Would the Cryomaze procedure prevent me from practicing yoga afterwards or running? How long before I could? Handstands? inversion poses. This a-fib is very frustrating to me. Even getting a cold has become debilitating as I go into a-fib from sneezing and the stress of the cold. I was hoping that it would go away when I go through menopause. I started taking magnesium and other supplements. I don't wish to take a month off from work. Could I go back to work sooner? No, the CryoMaze procedure should not prevent you from practicing yoga or running afterwards. Depending on your recovery, you could ease into running and yoga just after a few weeks (some people start running even earlier). It is not necessary to take off a month from work. If you are feeling well enough, you can go back to work as early as you'd like. We leave that decision-making up to you. I would be more than happy to discuss all of this in detail with you and to help determine if you're a candidate for this procedure. Please do not hesitate to contact me. My name is Mary- I'm Dr. Gammie's physician assistant. I can be reached at 410-328-5842. I look forward to speaking with you soon.
Q : 5 10/07/2008	Does CryoMaze still require cardioplegia? How many patients need post-op amiodarone? Does fixing a mitral annulus abolish AF in some cases? Yes, the CryoMaze procedure requires the administration of cardioplegia. This is necessary to arrest the heart in order for the internal cryomaze lesions to be made and to allow Dr. Gammie access to oversee the left atrial appendage. I am not certain of the percentage of patients who need amiodarone post-op. However, some of our patients are indeed placed on amiodarone post-op, even if they were not on this medication pre-op. Yes, repairing the mitral valve does sometimes improve/abolish AF. If you have further questions, please do not hesitate to contact me. My name is Mary- I'm Dr. Gammie's physician assistant. I can be reached at 410-328-5842.
Q : 6 06/09/2008	Dr. Gammie, Is CryoMaze the same as cryoblation? Is it successful in cases of AT? Yes, the CryoMaze procedure is the same thing as cryoablation. Although AT can be treated with ablative therapy, we here at the University of Maryland Medical center use the Cryomaze procedure to treat Atrial Fibrillation. You should talk to your local Electrophysiology doctors to discuss your options. My name is Mary- I'm Dr. Gammie's physician assistant. If you have any further questions, do not hesitate to contact me at 410-328-5842.
Q : 7 06/02/2008	Is your CryoMaze procedure similar to what is being tried (over trial period) during the Stop AF trials at Mass General and Mayo Clinic? Also, what short term living arrangements are available for out of state patients who desire your services? Yes, it's similar in that we use CryoMaze/cryoablation(just with a different company), however we are not enrolled in the "Stop AF" trial. Dr. Gammie, here at the University of Maryland Medical Center, has been performing the CryoMaze procedure for a few years now and has had good success. He has one of the highest CryoMaze volumes in the country for this procedure. We operate on a large volume of out-of-state patients and therefore have a nice setup for these patients. I would be more than happy to discuss all of this with you. My name is Mary, and I'm Dr. Gammie's physician assistant. Please do not hesitate to contact me. I can be reached at 410-328-5842 or msantos@smail.umaryland.edu.
Q : 8 02/19/2008	For CryoMaze, what is the in-hospital, and out-of-work time? In hospital time is approximately 3-5 days, barring complications. Out-of-work time varies from patient to patient. However, most patients go back to work in about one month from their operation date.
Q : 9 02/13/2008	I have AF that stays in the AF mode for long periods of time. I am 57 years old and otherwise in good health. Can you give me a ballpark idea of the cost of the CryoMaze procedure? And is it covered by most insurance plans if you get a physician referral for the procedure? How long does recovery typically take? Yes, the CryoMaze procedure should be covered by your insurance plan. Your hospital stay will be approximately 3-5 days and your recovery time will be about 4-6 weeks. The cost for the procedure is highly variable depending on several factors which would be difficult for me to go into. If you would like to discuss this further, please email me at msantos@smail.umaryland.edu or call me at 410-328-5842. My name is Mary- I'm a physician assistant who works closely with Dr. Gammie. I look forward to hearing back from you.
Q : 10 09/29/2007	I had the CryoMaze done at the end of August of this year. I am still very exhausted and have little palpitations, but not as often. Will this go away and will I be able to walk up a flight of stairs without being so tired that I have to sit down for a few minutes or up to 20 minutes? My doctor couldn't answer these questions since he just started doing this procedure. I started a job after 2 1/2 years and have been back to the ER twice. Is it normal? I can't get any answers from my surgeon. Please fill me in on the after-affects of this procedure and about how long I will be exhausted and lose of sleep and have fatigue. One more thing, I have been seeing a therapist due to emotional problems that started after this procedure. Is that normal? I cry at little things that I use to think were funny. Even commercials get me emotional. Please get back to me as soon as possible. Regarding the CryoMaze procedure- it is likely that you will continue to have atrial fibrillation for a few to several months after your procedure. Your heart needs time to form scar tissue and remodel before seeing a huge improvement. This can take weeks to months. However, you should understand that the cryomaze procedure is not 100% effective at curing atrial fibrillation. In our hands, it is about 80% effective. Your symptoms are pretty common and should subside with time. Most people will start to feel back to normal by 6-8 weeks after their surgery. Another thing you should know is that depression is not uncommon after heart surgery. It is good that you are seeing a therapist for this. Sometimes antidepressant medication is necessary to get you over the hump of this depression. This can then be weaned off as your depression improves with time. My name is Mary Santos and I'm Dr. Gammie's physician assistant. I can be contacted at msantos@smail.umaryland.edu.
Q : 11 06/25/2007	I have HCM and paroxysmal atrial fibrillation. My atrium is 4.4 cm. I have minimal obstruction. What are the chances of successful ablation and also, can you tie off the atrial appendage with your technique? Our success rate for curing atrial fibrillation is about 80%, and we do suture ligate the atrial appendage with all of our CryoMaze procedures. I would be more than happy to discuss this with you in more detail. My name is Mary Santos and I'm Dr. Gammie's physician assistant. Please feel free to call me at 410-328-5842.
Q : 12 01/07/2007	Is the CryoMaze procedure as effective as the (cut & sew) Cox MAZE III Procedure? The Cox Maze III procedure has about a 96% success rate, and our Cryomaze procedure has about an 85-90% success rate at curing Afib. However, the Cox Maze III procedure is much more invasive an operation than the CryoMaze procedure, likely carrying a higher risk of complications due to bleeding and a longer time on the heart-lung machine which may result in kidney complications. For some eligible patients, the CryoMaze procedure may even be performed minimally invasively through a small 2.5 inch incision under the right nipple or breast (if performed here by Dr. Gammie). If you would like to learn more about the CryoMaze procedure that Dr. Gammie performs here at the University of Maryland Medical Center, please do not hesitate to call me. My name is Mary Santos, and I'm Dr. Gammie's physician assistant. I can be reached at 410-328-8470. I would be more than happy to speak with you.
Q : 13 11/12/2006	I have been diagnosed with lone atrial fibrillation five weeks ago. I have had a stress echo with negative findings, I am 56 years old and in good health other than the AFib. I have tried Toprol, Sotalol, and Norpace. Each drug worked for 2o r 3 days and then the AFib returns. It normally returns in the evening for about 4 hours and converts on its own and I often wake up at 4 or 5 a.m. in AFib and it converts back in 3 or 4 hours. My doctor wants to try one or two more drugs and then look at ablation procedure. I am an airline pilot and am currently grounded until this AFib can be resolved. Would CryoMaze be an option? Yes, CryoMaze does sound like an option for you. We here at the University of Maryland Medical Center have a success rate of 80-85% of curing AFib. My name is Mary, and I'm Dr. Gammie's physician assistant. I would be more than happy to discuss this procedure with you as well as your candidacy. Please feel free to contact me at at 410-328-8470.
Q : 14 09/01/2006	I had rheumatic fever as a child in the 50's. I have mitral valve prolapse and this A-Fib is directly related to that, I am told. I have lived my life in A-Fib for the last six years. I've had four cardioversions and they have not worked. Can this really help me? The key isssue is how much mitral regurgitation you have (leak); if it is graded as severe, then you should have mitral valve repair and concomitant CryoMaze. We would be happy to see you.
Q : 15 07/04/2006	I am 68 years old and have had atrial fibrillation for 11 years. A cardioversion done 11 years ago did not work, but it was done again 3 years ago in conjunction with amiodarone and I was back in sino for 8 days. My electrocardiologist does not think radio ablation is going to work after so many years in A.F. and I am considering CryoMaze. How many CryoMaze procedures have been done and what is the success rate? I have done nearly 150 cryomaze procedures; in our hands 85 percent of patients are in regular rhythm by six months after the procedure.

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