Staged hybrid totally thoracoscopic maze and catheter ablation for atrial fibrillation

Andrei Churyla*, Rod Passman, Patrick M. McCarthy, Olga N. Kislitsina, Jane Kruse, James L. Cox

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations


Introduction: Atrial fibrillation (AF) is a growing health problem and is associated with increased risk of stroke. The Cox-Maze surgical procedure has offered the highest success rate, but utilization of this technique is low due to procedure invasiveness and complexity. Advances in catheter ablation and minimally invasive surgical techniques offer new options for AF treatment. Methods: In this review, we describe current trends and outcomes of minimally invasive treatment of persistent and long-standing persistent AF. Results: Treatment of persistent and long-standing persistent AF can be successfully treated using a team approach combining cardiac surgery and electrophysiology procedures. With this approach, the 1-year freedom from AF off antiarrhythmic drugs was 85%. Discussion: There are a variety of techniques and approaches used around the world as technology evolves to help develop new treatment strategies for AF. Our report will focus on a hybrid treatment approach using surgical and electrophysiology approaches providing enhanced treatment options by replicating Cox-Maze IV lesions using skills from each specialty. Closure of the left atrial appendage as part of these procedures enhances protection from late stroke. A team approach provides a cohesive evaluation, treatment, and monitoring plan for patients. Development of successful, less invasive treatment options will help address the growing population of patients with AF.

Original languageEnglish (US)
Pages (from-to)1961-1965
Number of pages5
JournalJournal of cardiovascular electrophysiology
Issue number8
StatePublished - Aug 2022


  • atrial fibrillation
  • catheter ablation
  • thoracoscopic hybrid maze procedure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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