Atrial fibrillation: Should cardiac surgeons be consulted?

Abstract

The role of surgery in the treatment of arrhythmias has evolved due to improvements in catheter-based ablation techniques. In most centers, atrial fibrillation is now the only condition that is referred to the cardiac surgeon. The increasing demand for minimally invasive therapy gives the cardiologist first pick, but with the growing body of evidence there has been a shift back towards the surgeon. This chapter compares various surgical and catheter-based techniques and analyzes the current available outcome data. Although minimally invasive surgical approaches are increasing in popularity and have been shown to be safe and non-inferior to catheter ablation, they lack adequate follow-up data. Future data from randomized studies will clarify the role for the various approaches and formation of a multidisciplinary approach to the treatment of atrial fibrillation.