Peer-review started: May 29, 2015
First decision: July 10, 2015
Revised: August 8, 2015
Accepted: November 17, 2015
Article in press: November 25, 2015
Published online: January 26, 2016
Processing time: 239 Days and 11.6 Hours
Atrial fibrillation (AF) is the most common cardiac arrhythmia and a huge public health burden associated with significant morbidity and mortality. For decades an increasing number of patients have undergone surgical treatment of AF, mainly during concomitant cardiac surgery. This has sparked a drive for conducting further studies and researching this field. With the cornerstone Cox-Maze III “cut and sew” procedure being technically challenging, the focus in current literature has turned towards less invasive techniques. The introduction of ablative devices has revolutionised the surgical management of AF, moving away from the traditional surgical lesions. The hybrid procedure, a combination of catheter and surgical ablation is another promising new technique aiming to improve outcomes. Despite the increasing number of studies looking at various aspects of the surgical management of AF, the literature would benefit from more uniformly conducted randomised control trials.
Core tip: The surgical management of atrial fibrillation (AF) is a rapidly developing field. Existing surgical techniques are constantly evolving in order to achieve more minimally invasive procedures. Additionally, the relatively new ablative modalities are being increasingly used, either alone or in conjunction with surgical techniques; attempting overall better and less invasive results. This review looks at the current surgical techniques and ablative modalities available for managing AF, where each section is re-enforced with the current most up to date guidelines on the use of each of these modalities.