Early Results of the Modified Right Atrial Lesion Set for the Cox-Cryomaze Procedure

The electrophysiologic basis for lesions of the contemporary Maze operation

“…Because the only reason this lesion was introduced with the Maze II procedure and retained in the Maze III and Maze IV procedures was to prevent macro-reentry around the base of the RA appendage, 2,3,25 it was suggested that the same goal could be realized by moving the lesion to a more readily accessible location on the RA free-wall ( Figure 4, C and D). Cheema and colleagues 26 have performed more than 100 Maze IV procedures using this modification of the RA lesions without any change in the success rate or pacemaker requirements compared with the previous ''10 o'clock'' lesion of the Maze III and Maze IV procedures. The only important caveat is that this lesion must be placed as anteriorly as possible on the RA free-wall to avoid injury to the atrial pacemaker complex.…”