title: Stand alone surgical ablation for atrial fibrillation.
abstract: BACKGROUND
  Trials to maintain sinus rhythm in patients with atrial fibrillation (AF) and refractory symptoms have been complicated by lack of success or intolerance of medications. Experience with minimally invasive AF surgery is relatively new, and early results have been promising. However, the study populations and techniques were heterogeneous, and the follow-up periods were short in many series.
  
  
  METHODS
  We present a single center experience through a retrospective review of medical records of patients who had minimally invasive AF surgery.
  
  
  RESULTS
  The surgical techniques addressed several possible mechanisms of AF and causes of recurrence, including pulmonary vein isolation, underlying substrates modification, ligament of Marshall interruption, ganglion plexus ablation, and left atrial appendage exclusion. Thirty-three cases were identified. The mean duration of follow-up was 23.2 months, and 58.6% were maintained in a sinus rhythm and were off antiarrhythmic drugs at the end of the follow-up period. Cases with persistent AF had a lower success rate.
  
  
  CONCLUSIONS
  Results with minimally invasive surgery are suboptimal at two years of follow-up, particularly for patients with persistent AF.
authors.affiliation: Department of Cardiovascular Diseases, University of Cincinnati, Cincinnati, Ohio, USA. abosaled@ucmail.uc.edu
authors.forename: Elsayed
authors.initials: E
authors.lastname: Abo-Salem
authors.forename: Ralph F
authors.initials: RF
authors.lastname: Paone
authors.forename: Kenneth
authors.initials: K
authors.lastname: Nugent
authors.forename: Alejandro
authors.initials: A
authors.lastname: Perez-Verdia
authors.forename: Alok
authors.initials: A
authors.lastname: Deshpande
authors.forename: Hoda Mojazi
authors.initials: HM
authors.lastname: Amiri
mesh_terms: D000368:Aged; D020517:Atrial Appendage / Q000294:innervation / Q000601:surgery; D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods; D015331:Cohort Studies; D003131:Combined Modality Therapy; D015897:Comorbidity; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D011667:Pulmonary Veins / Q000294:innervation / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D017792:Surgical Stapling; D014630:Vagus Nerve / Q000503:physiopathology