Surgical treatment of lone atrial fibrillation has evolved from the complex Cox-Maze III procedure to less invasive ablation technologies and the Cox-Maze IV procedure.
This review highlights the evolution of surgical treatments for lone atrial fibrillation from the traditional Cox-Maze III to less invasive Cox-Maze IV and ablation techniques.
For two decades, the cut-and-sew Cox-Maze III procedure was the gold standard for the surgical treatment of atrial fibrillation (AF), and proved to be effective at curing lone AF and preventing its most dreaded complication, stroke. However, this procedure was not widely adopted due to its complexity and technical difficulty. Over the last 5-10 years, the introduction of new ablation technology has led to the development of the Cox-Maze IV procedure, as well as, more limited lesion sets, with the ultimate goal of performing a minimally-invasive lesion set on the beating heart, without the need for cardiopulmonary bypass. This review summarizes the current state of the art and future directions in the surgical treatment of lone atrial fibrillation. The hope is that as we learn more about the mechanisms of AF and develop preoperative diagnostic technologies capable of precisely locating the areas responsible for AF, it will become possible to tailor specific lesion sets and ablation modalities to individual patients, making the surgical treatment of lone AF available to a larger population of patients.
Shen et al. (Tue,) conducted a review in Lone atrial fibrillation. Surgical treatment (Cox-Maze procedures and ablation) was evaluated. Surgical treatment of lone atrial fibrillation has evolved from the complex Cox-Maze III procedure to less invasive ablation technologies and the Cox-Maze IV procedure.
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