Surgery for atrial fibrillation.

Atrial fibrillation is the most common sustained cardiac arrhythmia and is associated with significant morbidity and mortality. Surgical treatment is the most effective means of curing atrial fibrillation. The classic Cox maze procedure eliminates atrial fibrillation in more than 90% of patients and has remained the gold standard in surgery for atrial fibrillation. Despite being highly effective, the complexity of the procedure and long operating time associated with the operation has prevented its widespread application by surgeons. Advances in the understanding of the pathogenesis of atrial fibrillation and development of new ablation technologies have fuelled renewed interest in and development of surgical ablation procedures for atrial fibrillation. These new procedures are simpler and easily reproducible and cure atrial fibrillation in approximately 80% of patients. This article reviews the development of surgery for atrial fibrillation and our experience with the radiofrequency Cox maze III procedure.