Atrial fibrillation: Current and emerging surgical strategies.

ABSTRACT

OBJECTIVE: (a) To provide a comprehensive review of current literature on the surgical management of atrial fibrillation (AF), highlighting surgical approaches and outcomes. (b) To summarize the latest guidelines pertinent to the surgical management of AF. BACKGROUND: AF is associated with high rates of morbidity and mortality, primarily related to the associated risk of stroke. The mainstay of management is pharmacologic rate or rhythm control and catheter-based ablation. Surgical ablation (SA) is an alternative strategy that is effective in select patient populations. Recently, novel techniques and technologies have been introduced and this has expanded the surgical capacity to manage AF. METHODS: A comprehensive review of the literature was conducted. RESULTS: Surgery can be a highly effective alternative therapeutic option for the management of AF in the appropriate patient population. The need for permanent pacemaker implantation is controversial among patients undergoing surgical intervention for AF. Surgical outcomes are promising, with long-term control of AF and symptomatic relief achieved in select groups of patients. CONCLUSIONS: This article provides a comprehensive review of the surgical management of AF. We have summarized the latest surgical outcomes and contextualized the most recent guidelines.