The surgical treatment of atrial fibrillation
Open accessAbstract
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.
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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]”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [784]
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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.
- ORCID
- Cain, Michael E.
- 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
- bronze
- doi.org
- Licence
- 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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