Surgical Management of Atrial Fibrillation

Atrial fibrillation (AF) is an epidemic. Conservative management by pharmacological therapy and catheter ablation have had limited success and has justified a role for surgical ablation. The full Cox-Maze procedure, performed as a stand-alone or concomitant to other procedures, through a sternotomy or a right mini-thoracotomy, represents the gold standard in AF ablation. Minimally invasive and hybrid procedures are hampered by their inability to consistently create continuous and transmural ablation lines and therefore have had inconsistent results in clinical reports. Work is in progress to develop a minimally invasive, off-pump, complete Cox–Maze procedure.