Abstract
Atrial fibrillation is the most common cardiac arrhythmia and is associated with significant morbidity. Medical management of atrial fibrillation is often suboptimal and is challenged by many patient-related or therapy-related difficulties. Surgical options for atrial fibrillation aim to provide an improved efficacy therapy that avoids the shortcomings of lifelong anticoagulation and anti-arrhythmic therapy and/or lifestyle change. The introduction of ablation devices has revolutionized the surgical treatment of AF making procedures available to a wider patient population.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Corley SD, Epstein AE, et al. Relationships between sinus rhythm, treatment, and survival in the atrial fibrillation follow-up investigation of rhythm management (AFFIRM) study. Circulation. 2004;109:1509–13.
Wyse DG, Love JC, et al. Atrial fibrillation: a risk factor for increased mortality--an AVID registry analysis. J Interv Card Electrophysiol. 2001;5:267–73.
Leong DP, Eikelboom JW, et al. Atrial fibrillation is associated with increased mortality: causation or association? Eur Heart J. 2013;34:1027–30.
Wyse DG, Waldo AL, et al. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. 2002;347:1825–33.
Van Gelder IC, Hagens VE, et al. A comparison of rate control and rhythm control in patients with recurrent persistent atrial fibrillation. N Engl J Med. 2002;347:1834–40.
Calkins H, Hindricks G, et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Heart Rhythm. 2017;14:e275–444.
Bedeir K, Giugliano RP, et al. Chronic anticoagulation in non-valvular atrial fibrillation: where things stand. Int J Cardiol. 2016;222:615–9.
Damiano RJ Jr, Schwartz FH, et al. The Cox maze IV procedure: predictors of late recurrence. J Thorac Cardiovasc Surg. 2011;141:113–21.
Leitch JW, Klein G, et al. Sinus node-atrioventricular node isolation: long-term results with the “corridor” operation for atrial fibrillation. J Am Coll Cardiol. 1991;17:970–5.
Defauw JJ, Guiraudon GM, et al. Surgical therapy of paroxysmal atrial fibrillation with the “corridor” operation. Ann Thorac Surg. 1992;53:564–70.
Cox JL, Schuessler RB, et al. The surgical treatment of atrial fibrillation. I. Summary of the current concepts of the mechanisms of atrial flutter and atrial fibrillation. J Thorac Cardiovasc Surg. 1991;101:402–5.
Cox JL, Canavan TE, et al. The surgical treatment of atrial fibrillation. II. Intraoperative electrophysiologic mapping and description of the electrophysiologic basis of atrial flutter and atrial fibrillation. J Thorac Cardiovasc Surg. 1991;101:406–26.
Cox JL, Schuessler RB, et al. The surgical treatment of atrial fibrillation. III. Development of a definitive surgical procedure. J Thorac Cardiovasc Surg. 1991;101:569–83.
Cox JL. The surgical treatment of atrial fibrillation. IV. Surgical technique. J Thorac Cardiovasc Surg. 1991;101:584–92.
Cox JL, Schuessler RB, et al. An 8 1/2-year clinical experience with surgery for atrial fibrillation. Ann Surg. 1996;224:267–73.
Cox JL, Jaquiss RD, et al. Modification of the maze procedure for atrial flutter and atrial fibrillation. II. Surgical technique of the maze III procedure. J Thorac Cardiovasc Surg. 1995;110:485–95.
Cox JL, Ad N, et al. Current status of the Maze procedure for the treatment of atrial fibrillation. Semin Thorac Cardiovasc Surg. 2000;12:15–9.
Schaff HV, Dearani JA, et al. Cox-Maze procedure for atrial fibrillation: Mayo Clinic experience. Semin Thorac Cardiovasc Surg. 2000;12:30–7.
McCarthy PM, Gillinov AM, et al. The Cox-Maze procedure: the Cleveland Clinic experience. Semin Thorac Cardiovasc Surg. 2000;12:25–9.
Prasad SM, Maniar HS, et al. The Cox maze III procedure for atrial fibrillation: long-term efficacy in patients undergoing lone versus concomitant procedures. J Thorac Cardiovasc Surg. 2003;126:1822–8.
Gaynor SL, Schuessler RB, et al. Surgical treatment of atrial fibrillation: predictors of late recurrence. J Thorac Cardiovasc Surg. 2005;129:104–11.
Cox JL, Ad N, et al. Impact of the maze procedure on the stroke rate in patients with atrial fibrillation. J Thorac Cardiovasc Surg. 1999;118:833–40.
Pasic M, Musci M, et al. Transient sinus node dysfunction after the Cox-maze III procedure in patients with organic heart disease and chronic fixed atrial fibrillation. J Am Coll Cardiol. 1998;32:1040–7.
Damiano RJ Jr, Bailey M, et al. Multimed Man Cardiothorac Surg. 2007;2007(723):mmcts 2007.002758.
Gaynor SL, Ishii Y, et al. Successful performance of Cox-Maze procedure on beating heart using bipolar radiofrequency ablation: a feasibility study in animals. Ann Thorac Surg. 2004;78:1671–7.
Gaynor SL, Diodato MD, et al. A prospective, single-center clinical trial of a modified Cox maze procedure with bipolar radiofrequency ablation. J Thorac Cardiovasc Surg. 2004;128:535–42.
Damiano RJ, Gaynor SL. Atrial fibrillation during mitral valve surgery using the Atricure Device. Oper Tech Thorac Cardiovasc Surg. 2004;9:24–33.
Doll N, Kornherr P, et al. Epicardial treatment of atrial fibrillation using cryoablation in an acute off-pump sheep model. Thorac Cardiovasc Surg. 2003;51:267–73.
Weimar T, Bailey MS, et al. The Cox-maze IV procedure for lone atrial fibrillation: a single center experience in 100 consecutive patients. J Interv Card Electrophysiol. 2011;31:47–54.
Lall SC, Melby SJ, et al. The effect of ablation technology on surgical outcomes after the Cox-maze procedure: a propensity analysis. J Thorac Cardiovasc Surg. 2007;133:389–96.
Haissaguerre M, Jais P, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med. 1998;339:659–66.
Bagge L, Blomstrom P, et al. Epicardial off-pump pulmonary vein isolation and vagal denervation improve long-term outcome and quality of life in patients with atrial fibrillation. J Thorac Cardiovasc Surg. 2009;137:1265–71.
Han FT, Kasirajan V, et al. Results of a minimally invasive surgical pulmonary vein isolation and ganglionic plexi ablation for atrial fibrillation: single-center experience with 12-month follow-up. Circ Arrhythm Electrophysiol. 2009;2:370–7.
Edgerton JR, Brinkman WT, et al. Pulmonary vein isolation and autonomic denervation for the management of paroxysmal atrial fibrillation by a minimally invasive surgical approach. J Thorac Cardiovasc Surg. 2010;140:823–8.
Gaita F, Riccardi R, et al. Linear cryoablation of the left atrium versus pulmonary vein cryoisolation in patients with permanent atrial fibrillation and valvular heart disease: correlation of electroanatomic mapping and long-term clinical results. Circulation. 2005;111:136–42.
Ramlawi B, Bedeir K. Surgical options in atrial fibrillation. J Thorac Dis. 2015;7:204–13.
Gillinov AM, Gelijns AC, et al. Surgical ablation of atrial fibrillation during mitral-valve surgery. N Engl J Med. 2015;372:1399–409.
Barnett SD, Ad N. Surgical ablation as treatment for the elimination of atrial fibrillation: a meta-analysis. J Thorac Cardiovasc Surg. 2006;131:1029–35.
Boersma LV, Castella M, et al. Atrial fibrillation catheter ablation versus surgical ablation treatment (FAST): a 2-center randomized clinical trial. Circulation. 2012;125:23–30.
Kearney K, Stephenson R, et al. A systematic review of surgical ablation versus catheter ablation for atrial fibrillation. Ann Cardiothorac Surg. 2014;3:15–29.
Pison L, La Meir M, et al. Hybrid thoracoscopic surgical and transvenous catheter ablation of atrial fibrillation. J Am Coll Cardiol. 2012;60:54–61.
Muneretto C, Bisleri G, et al. Durable staged hybrid ablation with thoracoscopic and percutaneous approach for treatment of long-standing atrial fibrillation: a 30-month assessment with continuous monitoring. J Thorac Cardiovasc Surg. 2012;144:1460–5.
La Meir M, Gelsomino S, et al. The hybrid approach for the surgical treatment of lone atrial fibrillation: one-year results employing a monopolar radiofrequency source. J Cardiothorac Surg. 2012;7:71.
Bisleri G, Rosati F, et al. Hybrid approach for the treatment of long-standing persistent atrial fibrillation: electrophysiological findings and clinical results. Eur J Cardiothorac Surg. 2013;44:919–23.
Wolf PA, Abbott RD, et al. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991;22:983–8.
Stollberger C, Chnupa P, et al. Mortality and rate of stroke or embolism in atrial fibrillation during long-term follow-up in the embolism in left atrial thrombi (ELAT) study. Clin Cardiol. 2004;27:40–6.
Onalan O, Lashevsky I, et al. Nonpharmacologic stroke prevention in atrial fibrillation. Expert Rev Cardiovasc Ther. 2005;3:619–33.
Rosendaal FR, Cannegieter SC, et al. A method to determine the optimal intensity of oral anticoagulant therapy. Thromb Haemost. 1993;69:236–9.
Adjusted-dose warfarin versus low-intensity, fixed-dose warfarin plus aspirin for high-risk patients with atrial fibrillation: stroke prevention in atrial fibrillation III randomised clinical trial. Lancet. 1996;348:633–8.
Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg. 1996;61:755–9.
Garcia-Fernandez MA, Perez-David E, et al. Role of left atrial appendage obliteration in stroke reduction in patients with mitral valve prosthesis: a transesophageal echocardiographic study. J Am Coll Cardiol. 2003;42:1253–8.
Almahameed ST, Khan M, et al. Left atrial appendage exclusion and the risk of thromboembolic events following mitral valve surgery. J Cardiovasc Electrophysiol. 2007;18:364–6.
Bando K, Kobayashi J, et al. Early and late stroke after mitral valve replacement with a mechanical prosthesis: risk factor analysis of a 24-year experience. J Thorac Cardiovasc Surg. 2003;126:358–64.
Bedeir K, Holmes DR, et al. Left atrial appendage exclusion: an alternative to anticoagulation in nonvalvular atrial fibrillation. J Thorac Cardiovasc Surg. 2017;153:1097–105.
Holmes DR, Reddy VY, et al. Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet. 2009;374:534–42.
Reddy VY, Doshi SK, et al. Percutaneous left atrial appendage closure for stroke prophylaxis in patients with atrial fibrillation: 2.3-year follow-up of the PROTECT AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients with Atrial Fibrillation) trial. Circulation. 2013;127:720–9.
Reddy VY, Sievert H, et al. Percutaneous left atrial appendage closure vs warfarin for atrial fibrillation: a randomized clinical trial. JAMA. 2014;312:1988–98.
Bartus K, Han FT, et al. Percutaneous left atrial appendage suture ligation using the LARIAT device in patients with atrial fibrillation: initial clinical experience. J Am Coll Cardiol. 2013;62:108–18.
Massumi A, Chelu MG, et al. Initial experience with a novel percutaneous left atrial appendage exclusion device in patients with atrial fibrillation, increased stroke risk, and contraindications to anticoagulation. Am J Cardiol. 2013;111:869–73.
Stone D, Byrne T, et al. Early results with the LARIAT device for left atrial appendage exclusion in patients with atrial fibrillation at high risk for stroke and anticoagulation. Catheter Cardiovasc Interv. 2015;86:121–7.
Salzberg SP, Plass A, et al. Left atrial appendage clip occlusion: early clinical results. J Thorac Cardiovasc Surg. 2010;139:1269–74.
Ailawadi G, Gerdisch MW, et al. Exclusion of the left atrial appendage with a novel device: early results of a multicenter trial. J Thorac Cardiovasc Surg. 2011;142:1002–9, 9 e1.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Bedeir, K., Ramlawi, B. (2020). Surgical Management of Atrial Fibrillation. In: Raja, S. (eds) Cardiac Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-24174-2_79
Download citation
DOI: https://doi.org/10.1007/978-3-030-24174-2_79
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-24173-5
Online ISBN: 978-3-030-24174-2
eBook Packages: MedicineMedicine (R0)