Current Status of Atrial Fibrillation Ablation Surgery

Surgical atrial fibrillation (AF) ablation has evolved from the cut-and-sew Cox-Maze III procedure to cryoablation, radiofrequency ablation, and minimally invasive approaches; however, reporting of rhythm outcomes lacks standardization. This review proposes standardized definitions of rhythm success, consistent monitoring using electrocardiography (ECG), Holter monitoring, mobile devices, or loop recorders, and clear reporting of antiarrhythmic drug use within and after blanking. Reports should also detail lesion sets, application method, device types, and bypass status. A complete Maze via right thoracotomy achieves superior rhythm outcomes with equivalent morbidity and mortality.