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Updated: Mar 24, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Surgery for Atrial Fibrillation
Christopher P Lawrance1, Matthew C Henn1, Ralph J Damiano1
1Division of Cardiothoracic Surgery, Barnes-Jewish Hospital, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8234, St Louis, MO 63110, USA.
Insights
The Cox-Maze IV procedure is an advanced surgical treatment for atrial fibrillation. This review covers its indications, planning, and compares its effectiveness to older surgical methods.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Atrial fibrillation is the most common cardiac arrhythmia.
- Treatment options include medication, catheter ablation, and surgery.
- Surgical treatment for atrial fibrillation has evolved significantly over time.
Purpose of the Study:
- To review the indications and preoperative planning for the Cox-Maze IV procedure.
- To compare the surgical results of Cox-Maze IV with the previous cut-and-sew method.
Main Methods:
- Review of literature on surgical treatment of atrial fibrillation.
- Focus on the Cox-Maze IV procedure and its evolution.
- Comparison of Cox-Maze IV outcomes with the cut-and-sew technique.
Main Results:
- The Cox-Maze procedure is the gold standard for surgical atrial fibrillation treatment.
- The Cox-Maze IV represents the latest iteration of this surgical approach.
- Literature review comparing Cox-Maze IV to the cut-and-sew method is presented.
Conclusions:
- The Cox-Maze IV procedure is a key surgical intervention for atrial fibrillation.
- Understanding indications and planning is crucial for successful Cox-Maze IV surgery.
- Comparative data highlights the advancements in surgical atrial fibrillation treatment.
Abstract:
Atrial fibrillation is the most common cardiac arrhythmia, and its treatment options include drug therapy or catheter-based or surgical interventions. The surgical treatment of atrial fibrillation has undergone multiple evolutions over the last several decades. The Cox-Maze procedure went on to become the gold standard for the surgical treatment of atrial fibrillation and is currently in its fourth iteration (Cox-Maze IV). This article reviews the indications and preoperative planning for performing a Cox-Maze IV procedure. This article also reviews the literature describing the surgical results for both approaches including comparisons of the Cox-Maze IV to the previous cut-and-sew method.
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