The surgical treatment of atrial fibrillation (AF) has evolved greatly with technologic advances in preoperative diagnosis, surgical techniques, and postoperative monitoring. Long-term benefits of sinus restoration include freedom from atrial arrhythmias and antiarrhythmic medications, reduction in stroke risk, improved quality of life, and potentially long-term survival. The recognition of these benefits, the development of ablation technologies, and the demonstrated safety and efficacy have increased adoption of surgical ablation, both as a stand-alone procedure and for concomitant cardiac operations. The choice of surgical approach and technique should be individualized to the patient’s history of AF, anatomic factors, risk of recurrence, and concomitant cardiac lesions.
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