Surgical Treatment of Atrial Fibrillation: An Update

Nina, Vinicius José da Silva; Murad, Henrique; Leal, João Ferreira; Lucchesi, Fernando Antonio; Almeida, Rui M. S.; Judas, Gustavo Ieno; Brofman, Paulo Roberto Slud; Brandão, Carlos Manuel de Almeida; Lima, Luiz Cláudio Moreira; Campagnucci, Valquíria Pelisser

doi:10.21470/1678-9741-2025-0903

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SPECIAL ARTICLE • Braz. J. Cardiovasc. Surg. 40 (06) • 2025 • https://doi.org/10.21470/1678-9741-2025-0903 linkcopy

Surgical Treatment of Atrial Fibrillation: An Update

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

In this article, the authors present the indication for surgical ablation of atrial fibrillation and of left atrial appendage occlusion. They also present technical aspects of Cox-Maze IV operation and of left atrial appendage clip occlusion. They discuss the result of those techniques and what the guidelines recommend for their use.

Keywords:
Atrial Fibrillation; Atrial Appendage; Surgical Instruments; Vascular Diseases.

Abbreviations, Acronyms & Symbols
AADs	= Antiarrhythmic drugs	LA	= Left atrium
AF	= Atrial fibrillation	LAA	= Left atrial appendage
BFR	= Bipolar radiofrequency	LOE	= Level of evidence
CABG	= Coronary artery bypass grafting	PVI	= Pulmonary vein isolation
CM-III	= Cox-Maze III	PVs	= Pulmonary veins
CM-IV	= Cox-Maze IV	RA	= Right atrium
CPB	= Cardiopulmonary bypass	RAA	= Right atrial appendage
CS	= Coronary sinus	SA	= Surgical ablation
HRS	= Heart Rhythm Society	STS	= Society of Thoracic Surgeons
IS	= Intercostal space	SVC	= Superior vena cava
IVC	= Inferior vena cava	TA	= Tricuspid annulus

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