Arrhythmias & electrophysiology
Atrial arrhythmia recurrence after the Maze procedure: Insights from catheter-based mapping
Authors' conclusion
Recurrent arrhythmias after Maze primarily result from PV reconnection and incomplete linear lesions. Cut-and-sew lesions demonstrate greater durability than thermal ablation.
Study context
- Population
- Patients after Maze procedure (2008–2023) requiring endocardial catheter ablation for recurrent atrial fibrillation (AF) or atrial flutter
- Participants
- 86 patients
- Exposure
- Recurrence mechanisms by Maze lesion type and concomitant surgery
- Outcome
- Mechanisms of recurrent atrial arrhythmias after Maze on electroanatomic mapping
Main finding
As reported in the abstract
Recurrence mechanisms · after 3-month blanking period
Odds ratio
0.07
P < 0.0001
Cut-and-sew Maze III vs Cryothermal · PV reconnection 5% vs 67%
Odds ratio
0.11
P < 0.0001
Cut-and-sew Maze III vs Radiofrequency · PV reconnection 5% vs 56%
- AF and atrial flutter recurrence
- 31.8%
- AF only
- 33.7%
- Atrial flutter only
- 33.7%
- PV reconnection among patients with initial PV isolation
- 78.3%
- Inducible macroreentrant flutter during mapping
- 77.9%
Observational data: associations, not effects.
Further findings
Flutter with vs without surgical LA appendage-to-mitral annulus lesion
- Overall flutter 100% vs 71.2%
- P = 0.005
- Left atrial flutter 80% vs 36.4%
- P = 0.001
- Atypical flutter 90% vs 50%
- P = 0.002
Flutter with vs without mitral valve repair
- Overall flutter 92.6% vs 71.2%
- P = 0.028
- Cavotricuspid isthmus flutter 55.6% vs 30.5%
- P = 0.033
- Atypical flutter 81.5% vs 49.2%
- P = 0.005
Original publication
Atrial arrhythmia recurrence after the Maze procedure: Insights from catheter-based mapping. Heart Rhythm. Published 14 November 2025. doi:10.
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