Contemporary surgical treatment for atrial fibrillation.
Traditional surgical treatment of AF is the Cox-Maze III procedure. The Cox-Maze III procedure cures AF in >90% of patients and virtually eliminates the risk of stroke. Recent understanding of the importance of the pulmonary veins and left atrium in the pathogenesis of AF has resulted in the development of new surgical approaches. New operations to ablate AF use alternate energy sources (radiofrequency, microwave, cryothermy) and simplified left atrial lesion sets. These operations cure AF in 70-80% of patients. This article describes contemporary and emerging surgical approaches to AF, synthesizes results of these operations, and proposes a strategy for choice of operation based on patient presentation.
Gillinov
A Marc
AM
Center for Atrial Fibrillation, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. gillinom@ccf.org
McCarthy
Patrick  M
P
Marrouche
Nassir
N
Natale
Andrea
A
D020517:Atrial Appendage / Q000601:surgery; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation; D003452:Cryosurgery; D006325:Heart Atria / Q000601:surgery; D006329:Heart Conduction System / Q000601:surgery; D006801:Humans; D008872:Microwaves / Q000627:therapeutic use; D011667:Pulmonary Veins / Q000601:surgery