Surgical and minimally invasive ablation for atrial fibrillation

Ralph J. Damiano, Rochus K. Voeller

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations


The Cox-Maze procedure, first introduced in 1987, has been the gold standard for the surgical treatment of atrial fibrillation. At 10 years, over 90% of patients remain free from atrial fibrillation. The procedure has been shown to be effective at eliminating the incidence of late stroke in this high-risk population. The development of new ablation technologies has greatly simplified and shortened the Cox-Maze procedure without sacrificing efficacy. These technologies have spurred interest in the development of new, simpler operations for the surgical treatment of atrial fibrillation that can be performed through minimal access and, in some instances, off of cardiopulmonary bypass. The early results with these more limited procedures on the whole have not been as good as with the Cox-Maze procedure, but they are promising. There are many problems with the development of a truly minimally invasive procedure with high efficacy. When patients are referred for surgery, there is no information available regarding the mechanisms of their atrial fibrillation. Thus, it is impossible to tailor the ablation to the individual patient. Future progress will require better understanding of the mechanisms of atrial fibrillation, and the development and refinement of clinical diagnostic technology that will allow for better preoperative diagnosis.

Original languageEnglish (US)
Pages (from-to)371-376
Number of pages6
JournalCurrent Treatment Options in Cardiovascular Medicine
Issue number5
StatePublished - Oct 2006


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