Maze

Q: What are the three principal goals of surgical intervention in atrial fibrillation?

Answer: 

• Creation of conduction block to disrupt all micro- and macro-reentrant circuits. 
• Reestablishment or maintenance of electrical atrioventricular synchrony. 
• Restoration of atrial mechanical function in order to improve diastolic filling.

The objective of the above pearl is to concisely put the surgical solution to atrial fibrillation. First two goals are well known but interestingly third and the most vital goal frequently goes unnoticed. 

#cardiology

#surgical-critical-care

Reference: 

Ferguson TB Jr, Cox JL. Surgery for atrial fibrillation. In: Cardiac Electrophysiology: From Cell to Bedside, 2nd ed, Zipes DP, Jalife J (Eds), Saunders, Philadelphia 1995. p.1567.