title: Surgical treatment of atrial fibrillation: today's questions and answers.
abstract: Although atrial fibrillation is common in cardiac surgery patients, the Cox maze IV procedure is underutilized; in contemporary practice, most cardiac surgery patients with atrial fibrillation do not receive concomitant surgical ablation. Available evidence suggests that a biatrial, energy-assisted Cox maze IV procedure restores normal sinus rhythm in two-thirds to three-quarters of patients without increasing operative risk. The best results are obtained by adherence to the correct lesion set and careful attention to perioperative management of heart rhythm and anticoagulation. To date, we have no randomized clinical trials confirming that surgical ablation improves clinical outcomes beyond restoration of sinus rhythm; however, available evidence does suggest that concomitant surgical ablation provides clinical benefit, most notably by reducing the long-term risk of stroke.
authors: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.. Electronic address: GILLINOM@ccf.org.
authors: Marc
authors: M
authors: Gillinov
authors: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.
authors: Edward
authors: E
authors: Soltesz
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D006329:Heart Conduction System / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D018579:Patient Selection; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome
keywords: atrial fibrillation; maze procedure; surgery