title: A Swedish consensus on the surgical treatment of concomitant atrial fibrillation.
abstract: Atrial fibrillation (AF) is a common arrhythmia among patients scheduled for open heart surgery and is associated with increased morbidity and mortality. According to international guidelines, symptomatic and selected asymptomatic patients should be offered concomitant surgical AF ablation in conjunction with valvular or coronary surgery. The gold standard in AF surgery is the Cox Maze III ("cut-and-sew") procedure, with surgical incisions in both atria according to a specified pattern, in order to prevent AF reentry circuits from developing. Over 90% of patients treated with the Cox Maze III procedure are free of AF after 1 year. Recent developments in ablation technology have introduced several energy sources capable of creating nonconducting atrial wall lesions. In addition, simplified lesion patterns have been suggested, but results with these techniques have been unsatisfactory. There is a clear need for standardization in AF surgery. The Swedish Arrhythmia Surgery Group, represented by surgeons from all Swedish units for cardiothoracic surgery, has therefore reached a consensus on surgical treatment of concomitant AF. This consensus emphasizes adherence to the lesion pattern in the Cox Maze III procedure and the use of biatrial lesions in nonparoxysmal AF.
authors.affiliation: Örebro University Hospital, Sweden. anders.ahlsson@orebroll.se
authors.forename: Anders
authors.initials: A
authors.lastname: Ahlsson
authors.forename: Lena
authors.initials: L
authors.lastname: Jidéus
authors.forename: Anders
authors.initials: A
authors.lastname: Albåge
authors.forename: Göran
authors.initials: G
authors.lastname: Källner
authors.forename: Anders
authors.initials: A
authors.lastname: Holmgren
authors.forename: Gabriella
authors.initials: G
authors.lastname: Boano
authors.forename: Ulf
authors.initials: U
authors.lastname: Hermansson
authors.forename: Per-Ola
authors.initials: PO
authors.lastname: Kimblad
authors.forename: Henrik
authors.initials: H
authors.lastname: Scherstén
authors.forename: Johan
authors.initials: J
authors.lastname: Sjögren
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Ståhle
authors.forename: Bengt
authors.initials: B
authors.lastname: Aberg
authors.forename: Eva
authors.initials: E
authors.lastname: Berglin
mesh_terms: D000465:Algorithms; D001281:Atrial Fibrillation / Q000473:pathology / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods; D006325:Heart Atria / Q000473:pathology / Q000601:surgery; D006801:Humans; D013548:Sweden