Cited by 1,464Atrial Fibrillation Management and OutcomesCardiac Arrhythmias and TreatmentsCardiac pacing and defibrillation studies

The surgical treatment of atrial fibrillation

Open access
Cox, James L., Schuessler, Richard B., D’Agostino, Harry J., Stone, Constance M., Chang, Byung-Chul, Cain, Michael E., Corr, Peter B., Boineau, John P.·1991·The Journal of Thoracic and Cardiovascular Surgery

Abstract

On the basis of the known electrophysiologic mechanisms of atrial fibrillation, multiple surgical procedures were designed and tested in dogs to determine the feasibility of developing a surgical cure for human atrial fibrillation. These experimental studies culminated in a surgical approach that effectively creates an electrical maze in the atrium. The atrial incisions prevent atrial reentry and allow sinus impulses to activate the entire atrial myocardium, thereby preserving atrial transport function postoperatively. Since September 1987, this surgical procedure has been applied in seven patients, five with paroxysmal atrial fibrillation of 2 to 9 years' duration and two with chronic atrial fibrillation of 3 and 10 years' duration. All seven patients have been cured of atrial fibrillation and none is receiving any postoperative antiarrhythmic medications.

Integrity signals

Registry

Crossref · 10.1016/s0022-5223(19)36684-x

Cites

36 of 36 references verified0 citation errors · 0 not checkable

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  • The Cox maze procedure and other forms of atrial fibrillation surgery have mainly been used in patients undergoing other open heart surgical procedures.

    “The Cox maze procedure and other, often simpler, forms of AF surgery have mainly been used in patients undergoing other open heart surgical procedures.461,466,[784][785][786][787][788][789][790][791][792][793][794][795][796][797][798]”

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Authors
Cox, J. L., Schuessler, R. B., D’Agostino, H. J., Stone, C. M., Chang, B.-C., Cain, M. E., Corr, P. B., & Boineau, J. P.
Affiliations
  • Barnes-Jewish Hospital (US)
  • Washington University in St. Louis (US)
Corresponding author
Cox, James L.
Venue
The Journal of Thoracic and Cardiovascular Surgery
Publisher
Elsevier BV
Published
1991-04
Volume
101
Issue
4
Pages
569-583
ISSN
0022-5223 (ISSN-L)
OpenAlex
W58578392
Cited by
1,464
References
36
Citations by year
2026: 9 · 2025: 16 · 2024: 21 · 2023: 24 · 2022: 26 · 2021: 33 · 2020: 30 · 2019: 26 · 2018: 33 · 2017: 52 · 2016: 40 · 2015: 57 · 2014: 65 · 2013: 55 · 2012: 67
FWCI
19.36
Type
journal article
Language
en
Open access
Locations
  • Journal of Thoracic and Cardiovascular Surgery (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01hl033722-14)
  • National Heart, Lung, and Blood Institute (R01-HL33722, R01-HL-32257, R01HL032257)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
Keywords
atrial fibrillation, surgical ablation, atrial reentry, paroxysmal atrial fibrillation, chronic atrial fibrillation, electrophysiologic mechanisms
MeSH terms
Adult, Animals, Atrial Fibrillation, Dogs, Echocardiography, Electrocardiography, Female, Hemodynamics, Humans, Male, Methods, Middle Aged

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