[Surgery for atrial fibrillation by the Cox technique. Apropos of 2 cases]

The authors report the cases of two patients who underwent surgery of atrial fibrillation by Cox's technique. In one case, it was associated with mitral valvuloplasty for atrial fibrillation of 4 years' duration; sinus rhythm was restored on the 19th postoperative day; it persisted at 11 months without antiarrhythmic drugs. On the other case, it was associated with mitral valve replacement for atrial fibrillation of 7 years' duration in a patient with dilated cardiomyopathy and a poor left ventricle; sinus rhythm was restored by electrical cardioversion during the 4th postoperative month; it persisted at 9 months with antiarrhythmic therapy. Cox's technique allows: 1) definitive suppression of atrial fibrillation, 2) restoration of atrioventricular synchronisation, 3) preservation of atrial transport function. The indications are paroxysmal or permanent atrial fibrillation, invalidating and resistant to medical therapy; atrial fibrillation of over 3 years' duration associated with mitral regurgitation requiring valvular repair and atrial fibrillation of invalidating primary cardiomyopathy.