The above information is presented for general information only. You should consult your physician personally to discuss your specific needs and how any of the above information may apply to you. Drs. Brown and Keith, and Midwestern Cardiac Surgery are not responsible for any misinterpretation or misapplication of the above information.

 2009 - Midwestern Cardiac Surgery. All rights reserved.

Cox-Maze Surgery

Atrial Fibrillation Surgery (Cox-Maze Surgery)

This is a surgical procedure developed by James Cox, M.D. that permanently repairs atrial fibrillation. Scars are made in the atria (upper chambers of the heart) that stop the formation and the conduction of errant electrial impulses. It channels the normal electrical impulse in one direction, restoring a normal rhythm. Dr. Brown was trained by Dr. Cox, while Dr. Cox was on staff at The Ohio State University.

Atrial Fibrillation

Atrial fibrillation is the most common abnormal heart rhythm. Normally the heart contracts and relaxes to a regular beat. The sinus node, located in the upper chamber (atria), is the heart's normal pacemaker. It sends electrical signals to the rest of the heart through the conduction system, which consists of the AV node, Bundle of His, bundle branches and Purkinje fibers. 

In atrial fibrillation, the sinus node does not start the electrical signal. Erratic signals come in an erratic fashion from the atrial muscle instead. The heart normally beats between 60-80 times a minute at rest. Because the heart is not beating normally in atrial fibrillation, blood is not completely emptied from the atria with each contraction. This can result in blood clots forming in the heart.  In some patients with atrial fibrillation, these blood clots can dislodge from the atria, resulting in a stroke. The American Heart Association estimates that over 70,000 strokes a year are caused by atrial fibrillation.


Palpitations               Irregular heart beat               Shortness of breath
Chest Discomfort       Weakness or Fatigue           Lightheadedness or dizziness 


It is important to realized that a patient's cardiologist (heart doctor) will determine what the most appropriate form of treatment will be. Some options include:
          Medication - Digoxin, calcium channel blockers, beta blockers, or other anti-arrhythmic drugs can help regulate the heart rate and rhythm
                             Coumadin or other anti-coagulants thin the blood and help prevent blood clots and strokes.
          Cardioversion - low energy electrical shock is applied through the skin to try and shock the heart back into a normal rhythm.
          Ablation - after an electrophysiology study is done to map the heart and determine where the atrial fibrillation is coming from, low frequency radio waves are applied to the area, in effect "burning" the source of the arrhythmia so it does not recur. Some ablation techniques require a permanent pacemaker insertion.
          Cox - Maze Surgery - a surgical procedure that permanently repairs atrial fibrillation.