HCM & AFib, Ablation or maze?

For hypertrophic cardiomyopathy with atrial fibrillation, catheter ablation is often the first option, while surgical ablation (Maze or Mini Maze) is a more definitive but invasive alternative for patients who don't respond to catheter ablation or are already undergoing open-heart surgery. The best choice depends on individual health, the complexity of the AFib, and whether other heart surgeries are needed.

Catheter Ablation

What it is: A minimally invasive procedure where catheters are guided through blood vessels to deliver energy (heat or cold) to create scar tissue, blocking abnormal electrical signals.

Pros: Less invasive than open-heart surgery.

Cons: Recurrence rates for AFib in HCM patients are higher compared to those without HCM, and multiple procedures may be needed.

Surgical Ablation (Maze)

What it is: A surgical procedure, often referred to as Cox Maze, that involves making precise cuts or using energy to create a maze-like pattern of scar tissue in the heart's upper chambers. It can be performed with open-heart surgery or a minimally invasive approach (Mini Maze).

Pros: More effective than catheter ablation for long-term rhythm control, with success rates of 80-90%. Can be combined with other heart surgeries, such as valve repair or coronary artery bypass surgery, in the same procedure.

Cons: More invasive than catheter ablation, with a longer recovery time.

How long did you have HCM before it became obstructive?

Mine is not obstructive, yet.

Better that it is not obstructive. I couldn't believe it when mine became obstructive early this year.

Are you having new or different symptoms or find out from an ECHO or MRI or some other test that it's become obstructive?