Mini- Maze vs Catheter Ablation

[OzJames]

hi everyone I’m due to go back to Cardiologist this week. Some of you great people had responded to someone’s question about how the mini maze works on the outside of heart and the Catheter ablation inside the heart. Comments like when working inside the heart it damages some important tissue? I’ve tried searching and can’t find the info. I’d like to ask the cardiologist for his thoughts.

I remain in sinus which is good post CV and am just getting my questions organised for the appointment.

Cheers James

[Mrsvemb]

A high percentage of cardiologists are either against the mini maze, or don’t know much about it.

A cardiologist works along side an EP who actually performs the ablations. Mini Maze is performed by a Cardiothoracic surgeon. It is minimally invasive and has a very high success rate.

The mini maze will also include clipping the left atrial appendage which will remove the need for anticoagulants. Also the aim is to get off of all AF related medication. This is a big positive for me as I cannot tolerate any of them.

By all means talk to your cardiologist about it, but you also need to do your own research and make your own decision.

Is mini maze an option in Australia?

I am having a mini maze here in the UK, in a little over two weeks time and I am hoping that it will give me my life back.

Having had no experience of catheter ablation, I can’t comment on it. Only hear of the experience of others.

Good luck with your appointment. Let us know what your cardiologist says.

[OzJames in reply to Mrsvemb]

I’ve noticed a few places have started mini maze and an other called Convergent mini maze in Australia, I guess not as experienced as in the UK and US. Thanks for info, I’ll check out the video

[MiniMeGreen]

Go to the page of Randall Wolf in Houston and look on his videos. He mentions that several times, specifically under the title Why catheter ablations fail from June 7th 2022.

[OzJames in reply to MiniMeGreen]

Thanks appreciate the info I’ll have a look today

[Lovefreedom]

Dr wolf minim maze...look up on YouTube under afib

[OzJames in reply to Lovefreedom]

Cheers will have a look

[ozziebob]

I suggest you look at the very informative Posts and Replies of saulger in which he clearly describes both his mini maze experience and the procedure itself as performed by Dr Ohtsuka in Tokyo (a colleague of the procedure's inventor Dr Wolf in Houston). Here's a link to saulger 's Posts ...

healthunlocked.com/user/sau....

And don't forget Dr Wolf has live 1 hour presentations on the Houston Methodist YouTube channel on the first Tuesday of each month (for 9 of 12 months each year), plus the helpful information on his website ...

wolfminimaze.com

Also, among saulger 's Replies you will find previous Forum discussions on the differences between one form of the minimaze and a catheter ablation procedure.

Good luck

bob

[OzJames in reply to ozziebob]

Thank you Bob for the links I’ll have a look

Cheers James

[ozziebob in reply to OzJames]

And Tokyo is probably easier to access from Australia than London where I am. Just a thought. 🤔

[OzJames in reply to ozziebob]

Yes I’ve been looking, there are some places here in Oz that do the mini maze in Brisbane but it’s fairly new started last year or so and Perth I think for a few years. Unless I can find someone really experienced here I’d rather head to Japan

[AussieAFibber in reply to OzJames]

do you know which cardiologist(s) in Perth are using this WMM or similar procedures ?

[OzJames in reply to AussieAFibber]

still researching but a hospital in Brisbane was saying they were the first last year to start in Brisbane and mentioned that Perth had been doing them for a few years. Are you in Perth?

[AussieAFibber in reply to OzJames]

Yes. We are in Perth. It would be great to find out who in Perth in doing them

[Hidden]

I have a Zoom appointment this week with Dr Ohtsuka - the doctor in Tokyo who is a colleague of Dr Wolf's and performs the mini maze. The cost is very reasonable for a procedure that involved (2.3 million Japanese yen). I'm leaning in that direction over ablation. The success rate is excellent for PAF, which I have - about 93%, plus no more meds including anticoagulants which is a big plus.

I've been weighing up going for a ablation rather than the mini maze and been in contact with the Royal Brompton hospital which is one of the centres of excellence in the UK with regards having a private initial appointment. I have to say, Dr Ohtsuka has been much more responsive than the Royal Brompton who have been a bit disappointing thus far.

As others have said, check out Dr Wolf's YouTube channel where he discusses his procedure. There's also an excellent video of Dr Wolf & Dr Ohtsuka discussing their procedures and the difference between them. I would recommend joining the Wolf/Ohtsuka Facebook group where you'll also gain a lot of useful information:. The group is called Wolf mini Maze - live Afib Free

Good luck!

[OzJames in reply to Hidden]

Thanks for reply, I’ll check that out. Can you ask him how many of his patients continued in NSR more than 3 years and any long term successes? What is your quick history with AF ?

Cheers James

[2018NSR in reply to OzJames]

This is Sandi. I am the admin for the Wolf mini maze Facebook group in the US. Dr Wolf and Dr Ohtsuka base their success rate in the mid nineties from being afib free for 6 years. Dr Wolf pioneered this procedure in 2003 and has patients out over 20 years afib free. His very first patient remains afib free. Dr Wolf trained Dr Ohtsuka in 2008 and he shares the same stellar results. Between them that have done over 6000 procedures.

[OzJames in reply to 2018NSR]

Thanks Sandi that is reassuring, I’m trying to find somewhere here in Sydney that do them. My cardiologist I saw yesterday for a review frowned when I said I was looking at WMM, he said it’s risky and there’s no Trials or studies showing they are better than catheter ablations.

[2018NSR in reply to OzJames]

That’s exactly what I would expect your EP to say. He is not a surgeon and cannot do this procedure. It carries the same risk as any surgery. Dr Wolf and Dr Ohtsuka have never had a death or phrenic nerve injury in 20 years. Everything is completed on the surface of the heart. The heart is never penetrated. Dr Wolf clamps the LAA and Dr Ohtsuka removes it. Just Drs choice and provides the same results. I do not know of anyone from Australia doing this. In your research tho instead of looking for mini maze look for convergent procedure as that is the procedure mostly being done in Europe now. It’s done differently than the mini maze but both are successful. Do consider Tokyo. It is very affordable. I have spoken with many from Australia and some have already gone and some in the planning stages. Best wishes.

[2018NSR in reply to OzJames]

I do have some stats done by Dr Ohtsuka that I could forward to you.

[OzJames in reply to 2018NSR]

Thank you so much Sandi appreciate that. I’m going ok atm but after a few cardioversions I’m doing my planning for the future !

[2018NSR in reply to OzJames]

I love that you are researching now for the future.

[Amiodaroneluck]

I've had both. It takes a lot longer to recover to the point where you can travel by air from an intercostal mini-maze because there's a risk of lung collapse from the mini-maze. Recovery from the catheter ablation was really quick. Neither were especially unpleasant beyond the fact you can spend time in the hospital and I hate hospitals. They worked for me as I've been in NSR for 14 years now. Knock on wood.

[Turquoise19 in reply to Amiodaroneluck]

Where did you have your minimaze Amio? NHS ?

[Amiodaroneluck in reply to Turquoise19]

I'm an American, so my insurance paid for the mini-maze. The surgery was done at Washington Methodist IIRC- which I think is also where Dick Cheney gets his hearts. In my case the mini-maze was only partially successful because of damage due to the trauma of a car wreck caused my pericardium to fuse to my myocardium in places and the surgeon could not completely access the troubling parts of my heart. A later catheter ablation took care of that.

[Turquoise19 in reply to Amiodaroneluck]

So all in all a job very well done for you, and still no need for anticoagulants?

[Amiodaroneluck in reply to Turquoise19]

No, I'm on Xarelto. Other than it being pretty messy when I get a cut, I've had no side effects from Xarelto, and I'm heterozygous for a coagulopathy allele so my cardiologist thinks it's wise to stay on it. Also, my grandfather and father died from clots so I'm not going to fight him over taking it. I feel for the folks that have problems with the new anti-coagulants. I'm thankful that I've not had severe side effects from Xarelto and amiodarone.

[Turquoise19 in reply to Amiodaroneluck]

I am on Edoxaban. No problem either. Though I do wonder how I may fare longer term when I had to start age 53

[OzJames in reply to Amiodaroneluck]

Thanks for info, 14 years is a great outcome! since the procedure have you been on any drugs to help? What was your brief history?