Schema of the maze procedure and the radial approach for atrial fibrillation

The large outer circle denotes the atria and its outer limit is bounded by the atrioventricular annular margins. The small circle indicates the sinoatrial node (SAN), the shaded area indicates the isolated portion of the atrium, and the atrial coronary arteries, arising at the atrioventricular groove, are also schematically drawn. Arrows indicate the activation wavefront from the sinoatrial node, radiating toward the annular margins. The radial approach (right panel) preserves a more physiologic activation sequence and the blood supply to most atrial segments, whereas the atrial incisions of the maze procedure (left panel) desynchronize the activation sequence, and some of the incisions cross the atrial coronary arteries.