Surgical ablation

Surgical ablation may be appropriate for patients undergoing open chest cardiac surgery for other indications, such as valve repair or replacement, or coronary artery bypass grafting.6 During the Maze procedure, for example, the surgeon makes numerous incisions in the atrium, forming lines of scar tissue. This blocks electrical conduction and so attenuates the abnormal activity underlining AF.11 The success of the Maze procedure varies between centres. Typically, however, 80–90% of patients are free from AF for a year following the Maze procedure. The minimally invasive Cox-Maze technique uses cryotherapy, radiofrequency or high-intensity focused ultrasound to create linear scars in the atrium.11

When to consider surgery for atrial fibrillation is discussed in the next section

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