Efficacy and Safety of Minimally Invasive Maze Versus Conventional Maze for the Treatment of Atrial Fibrillation: A Meta-Analysis of Clinical Outcomes

The minimally invasive MAZE (mi-MAZE) procedure, a less invasive form of conventional MAZE (c-MAZE) procedure developed by Dr. Randall Wolf, has demonstrated promising outcomes in the treatment of atrial fibrillation. We conducted a meta-analysis by searching PubMed, Embase, Cochrane, and clinical trials databases. After screening 3771 studies, we included 7 studies, a total of 1486 patients, in our analysis. We analyzed dichotomous and continuous outcomes, with 95% confidence intervals (CI), using RevMan 5.4. Heterogeneity was calculated by I ² and χ². P value <0.05 was deemed significant. This meta-analysis included 7 cohort studies involving 1486 patients. There was a significant decrease in length of hospital stay (days) in the mi-MAZE group (mean difference (MD), -1.22, 95% CI, -1.36 to -1.08, I ² = 97%). At both 6 months and 12 months, sinus rhythm maintenance in the mi-MAZE group was noninferior to the c-MAZE (6 months = odds ratio (OR), 1.48, 95% CI, 0.88-2.51, I ² = 0%, 12 months = risk ratio (RR), 0.99, 95% CI, 0.94-1.03, I ² = 38). mi-MAZE was noninferior to c-MAZE in the safety outcomes such as pneumonia (RR, 0.80, 95% CI, 0.46-1.41, I ² = 27%), stroke (RR, 0.54, 95% CI, 0.11-2.58), and kidney injury (RR, 1.18; 95% CI, 0.38-3.64). In our meta-analysis, mi-MAZE showed a reduction in the length of hospital stay. mi-MAZE was noninferior to c-MAZE in efficacy and safety outcomes. These trends warrant well-designed clinical trials to determine their clinical significance further.