title: Surgical Ablation of Atrial Fibrillation: is Electrical Isolation of the Pulmonary Veins a Must?
abstract: Ablation of atrial fibrillation (AF) is a well-established treatment option for patients with symptomatic AF refractory to antiarrhythmic drugs. The cornerstone of catheter ablation is electrical isolation of the pulmonary veins, since the pulmonary veins are the most common location for triggers of AF. Electrical reconnection of the pulmonary veins is associated with arrhythmia recurrence and therefore diminishes long-term success of catheter ablation of AF. Therefore, durable pulmonary vein isolation remains a condition sine qua non for catheter ablation of AF. The Cox-Maze procedure is considered an effective surgical cure of AF, however it has never been widely adopted due to its procedural complexity. Since the development of minimal invasive techniques for surgical AF treatment, surgical ablation of AF has regained interest. Most of the minimal invasive surgical AF ablations performed around the globe include pulmonary vein isolation as a part of the procedure. In this review, we explore the necessity of electrical isolation of the pulmonary veins in surgical AF ablation.
authors.affiliation: Department of Cardio-Thoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Bart
authors.initials: B
authors.lastname: Maesen
authors.affiliation: Department of Cardiac Surgery, Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: Ines
authors.initials: I
authors.lastname: Van-Loo
authors.affiliation: Department of Cardiology, aastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Laurent
authors.initials: L
authors.lastname: Pison
authors.affiliation: Department of Cardio-Thoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Cardiac Surgery, Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: Mark
authors.initials: M
authors.lastname: La-Meir
keywords: Atrial Fibrillation; Electrical Isolation; Pulmonary Veins