Successful Minimally Invasive Surgical Ablation of Atrial Fibrillation
A Call to Do Better
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See Article by Ad et al
In this issue, Ad et al1 report their results with a stand-alone minimally invasive Cox maze procedure. Their sizeable cohort consists of patients with largely long-standing persistent atrial fibrillation (AF).1 Ad et al1 should be congratulated on achieving such excellent surgical results over a long duration with an open-heart surgical procedure. In this group of difficult-to-treat patients, they achieved 78% freedom from atrial arrhythmias off antiarrhythmic drugs after 5 years, using Heart Rhythm Society follow-up guidelines. The patients also had improved quality of life and a remarkably low stroke rate despite the fact that 81% of the patients were eventually taken off anticoagulation. If all patients could be offered a single procedure to achieve 78% success at 5 years with no risk of mortality, the clinics of cardiac surgeons would be filled beyond capacity. Unfortunately, this is not the case, and we should be doing better.
The current report adds to the numerous studies in the literature demonstrating that surgical ablation reduces AF burden, is associated with a low postoperative stroke risk, and improves …