Seeking Honest Feedback on the Minimaze Procedure for Atrial Fibrillation

[FandMella]

Dear Forum Members,

I hope this message finds you well. I am currently exploring treatment options for atrial fibrillation (AFib) and would greatly appreciate hearing from those who have undergone the Minimaze procedure or have considered it.

I have a few questions and would be grateful for your honest feedback:

1. Has anyone here undergone the Minimaze procedure and found that it did not work for them? If so, what were your experiences and reasons for its ineffectiveness?

2. For those who have undergone the Minimaze procedure, are you completely satisfied with the results? Has it effectively resolved your burden with AFib?

3. Are there any members who have chosen not to opt for the Minimaze procedure? If so, could you please share your reasons for this decision?

4. Have any individuals experienced complications as a result of undergoing the Minimaze procedure? If so, what were they and how were they addressed?

5. Overall, are all members who have undergone the Minimaze procedure very satisfied with the outcome? If not, what aspects of the procedure or its outcomes were unsatisfactory?

Your honest thoughts and experiences are greatly valued and will help me make an informed decision about my own treatment journey. Thank you in advance for sharing your insights.

Fandmella 🙏🙏🙏

[johnMiosh]

Hi FandMella. I have just posted on my seventh anniversary of my mini-maze. Totally happy with everything (except for the bad drug reaction the day after)

[Mumursa]

I had a mini maze 4 years ago carried out by the same surgeon as JohnMiosh.

My AF gradually got worse until I also developed Flutter last year which resulted in several A&E visits. I am now in constant arrhythmia suppressed by digoxin. My heart has deteriorated moderately and is to be monitored annually. It’s had a lot of work done to it, it’s getting older and it hasn’t beat properly for years It doesn’t stop me doing much.

It was a tough procedure but I don’t regret trying it .

[MummyLuv in reply to Mumursa]

Sorry to read this Mumursa.

[mav7]

Welcome to the Forum, FandMella

As you can see by first 2 posts, there may be varied experiences but most will likely be positive. Each recommendation for the minimaze is determined by the evaluation by the cardiologist, EP, and surgeon. But the individual must elect.

If you elect to share, it would be helpful to give info on your afib history and any other heart or health conditions.

As I am sure you recognize, we are not medically trained and only share personal experiences which can be very helpful, but not final in individual cases. Your medical team is familiar with your individual case to make the recommendation.

There are numerous threads on the minimaze which you may want to access by using the search bar at top of page.

[MummyLuv]

I suspect most of our mini maze procedures will be a similar approach to the failed thoroscopic maze you started your journey with. Mine was certainly done that way and the same lession set your surgeon was aiming for. I used same surgeon as the two responders above.

There is definitely risk with mini maze like any heart procedure. Pleural effusion is fairly common. If you have lone afib you will likely have a more straightforward recovery than if you have other heart or medical conditions.

There are quite a few of Dr Wolf’s patients on here who I hope will reply too

[FandMella in reply to MummyLuv]

My dear,

The only reason behind the aborted procedure with my "Prof!" is that he resected 3/4 of my appendage, which led to the disaster. He did not ablate anything; rather, he was content that I was alive and didn't require emergency chest surgery.

by the way, I entered the clinic in SR, and left for home 10 days later with permanent AFIB!

how shall I rate such a Professor ?!!!

[Poochmom]

I can only share my experience. I had the minimaze procedure performed by Dr Randall K Wolf in Houston Texas. He pioneered the mini maze procedure over 20 years ago and performs it differently than the surgeons in the UK and elsewhere who by the way have developed their procedures based on Dr Wolf’s procedure albeit they do it with variations. He ablates the ganglionic plexi on the outside of the heart as he believes that lone AFib ( AFib without other heart co morbidities is a nerve problem and not a heart muscle problem. This is why he developed the procedure. He occludes the LAA so that no need for blood thinners ever in the future for AFib. He also helped develop the tools used in his procedure. There is also another cardio thoracic surgeon in Tokyo, Dr Toshiyo Ohtsuka, who was trained by Dr Wolf and does the same procedure. These doctors have both done more than 2,500 procedures and have had tremendous success. i would say that success is also dependent on the number of procedures a surgeon has done and his experience

Just for reference other surgeons in different parts of the world do a somewhat similar procedures but they are not the same as these two surgeons.

I chose the Wolf MiniMaze as my first choice after having paroxysmal AFib For 4 years progressively getting worse. I was not interested in having the inside of my heart burned up or my septum punctured with a catheter ablation. My AFib started out at once every two months and by the time I had my MiniMaze the episodes were coming every 5 days. I was on anti coagulants, beta blocker and Flecainide. My procedure was 21 months ago. I have not had one episode since my surgery. I would not hesitate for one second to do it over again. It was the best decision of my life. My LAA was clipped and I am on no meds. My recovery was uneventful although it took a few months to completely recover.

There are some people who develop AFlutter after the minimaze especially if they had prior ablations. It very often burns itself out with no further treatment required but if not, This is most often eliminated with an AFlutter ablation which is highly successful. Dr Wolf procedure is not a convergent where a catheter ablation is performed along with the MiniMaze.

[SwayzeCrazy7777_ in reply to Poochmom]

I am so glad you explained your experience with the Minimaze.. I have had 3 failed ablations and could not have the Vein If Marshall because when they tried to start my procedure my vein was not large enough to balloon.. I am in the process right now of going thru pre-op test before I meet with my surgeon on Monday... I have been in constant Afib/a flutter for almost 5 years and we have tried all oral medications which have not been able to control.. I was told my recovery time would ne 8-10 weeks. I am trying this and pray it works because my only option if this is unsuccessful is a AV nodal ablation..

Look forward to response.. Thanks

[Poochmom in reply to SwayzeCrazy7777_]

Yes you are on the right track. A nurse I know had three failed ablations and was told her only other option was pace and ablate. She declined and found Dr Wolf. She had her minimaze in 2018 and has been in NSR ever since. Prayers for a successful procedure. Yes it was about 3 months before I started to feel normal. It takes that long for the scars to heal and form and your heart will be angry for a while. The MiniMaze, at least Dr Wolf’s procedure, uses the atricure device to burn a complete line around the ganglionic plexi and pulmonary veins on the outside of the heart. . I am told it takes about 8 seconds to burn the line and it tells him when the line is complete. He then tests it to make sure it has all been ablated and no trigger nerves are still active. Does your surgeon clip the LAA with an atriclip?

[Cookie24 in reply to Poochmom]

Do you have a Watchman device? Do you take aspirin every day?

[Poochmom in reply to Cookie24]

No I do not have a watchman. I have an atriclip, a titanium clip that completely isolates the LAA. Dr Wolf does a TEE after placement to assure it is completely cut off. It will then shrivel up and die. The other good thing about that is that about 20% of people can have AFib coming from the LAA. I am not on aspirin or any other blood changing med.

the watchman is a mesh plug that is inserted into the LAA. It does not isolate it and can sometimes move thereby not completely closing it off and blood clots can still form in/on the watchman. That is why you must take aspirin for life with a watchman. Once completely clipped the atriclip does not move

[SwayzeCrazy7777_ in reply to Poochmom]

Thank you so much for the response ..I do have a watchman and when I had the stroke it did not catch it even though it is correctly placed and does have the tissue around it correctly therefore I will have a TEE while they are in doing the surgery.. I will possibly go to ICU after surgery and then to a step down unit.. My case is rather complicated having had the stroke after the watchman placement and SSS.. As I mentioned I will be having the Echo on Thursday and pray that my ejection fraction is still at 50% which is was a year ago. I am so ready to be able to do things again with friends and family and I have the faith that this surgery will give me the life I want back.. Thank you so so much for your response again..

[Poochmom in reply to SwayzeCrazy7777_]

I was in ICU for a day after my surgery also. It is a common practice I think because they need to monitor the heart right after surgery. For me, it was a wonderful experience and the surgeon and hospital were like a 5 star hotel. I couldn’t have been happier. Good luck and please check in to let us know how you are getting along

[SwayzeCrazy7777_ in reply to Poochmom]

I definitely will and thank you again so much

[4chickens]

I’m 11 months out from a hybrid mini maze again with the same surgeon as John and others in the uk. My initial recovery was pretty easy after the first week. Since Dec I’ve had 3 runs of AF all self terminating longest 4 days and shortest 2 hrs, all of these where infection driven 2x pneumonia 1 x milder chest infection. I’m on no heart medication but had to resume Apixaban (gave up arguing with dr re being not necessary) I’ve just had a 48hr tape and if all ok will then stop Apixaban.

I don’t for one minute regret my decision. Of course I’d of liked to be completely free of AF, up until Dec I’d forgotten I’d ever had it, and I’m hoping as I approach my year anniversary this will again become the case.

[Poochmom in reply to 4chickens]

Are you sure it’s AFib and not flutter? You are barely out of the blanking period at this point. Give it some time. You have an atriclip right? Some doctors are un educated when it comes to atriclip prayers it levels out and you will again be free of the monster.

[4chickens in reply to Poochmom]

I’m sure it was AF as it was confirmed by ecg plus it was easier to cope with than the atypical flutter I was in when I had the hybrid minimaze,I had the atrial clip fitted as you say many uneducated drs around. The good bit is I never used to self convert and before my surgery I had been in fast flutter for 10

months.

[Poochmom in reply to 4chickens]

Great news! It seems it was just the illnesses that triggered the AF and prior to healing. Fingers crossed!