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Proc (Bayl Univ Med Cent). 2012 Jul;25(3):218-23.

A review of current surgical treatment of patients with atrial fibrillation.

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Cardiopulmonary Research Science and Technology Institute, Dallas, Texas (Z. Edgerton) and Cardiac Surgery Specialists, The Heart Hospital, Baylor Regional Medical Center at Plano, Texas (J. Edgerton). Dr. Edgerton is a paid consultant for AtriCure, Inc. Zachary J. Edgerton has no financial interests to disclose.


Surgical therapy for patients with atrial fibrillation has undergone significant advances over the past 30 years. The Cox Maze III technique is currently the gold standard of care for these patients. However, Maze IV, a less complex procedure using alternative energy sources, is rapidly replacing the Cox Maze III in clinical practice. The use of alternative energy sources such as cryothermy and radiofrequency eliminates some of the "cut and sew" lesions of the Maze III, resulting in an easier and faster procedure with less morbidity. Video-assisted technology and hybrid procedures have further ushered in the future of surgical therapy. This article presents the latest surgical therapeutic options for patients with atrial fibrillation. The history of these procedures is presented, followed by a discussion of modern-era techniques, including concomitant ablation and standalone (also referred to as "lone") procedures. Finally, the article explores breaking developments and future directions for the surgical treatment of patients with atrial fibrillation.

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