Surgical Ablation of Atrial Fibrillation — When, Why, and How?
In 1987, Dr. James L. Cox performed the first maze procedure for surgical ablation of atrial fibrillation.1 Previous efforts at surgical correction were not uniformly successful, and some procedures corrected cardiac rhythm but did not restore synchronized atrial contraction. Cox's maze procedure, performed with a precise pattern of incisions and suturing of the right and left atria, proved highly successful in restoring sinus rhythm and, in many patients, reestablishing atrial transport function. There is, however, a lack of consensus regarding indications for surgical ablation of atrial fibrillation. In patients with structural heart disease, atrial fibrillation is a common coexisting problem, . . .DOI: 10.1056/NEJMe1501493