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

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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

DOI 10.1016/s0022-5223(19)36684-x

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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.

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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)
DOI: 10.1016/s0022-5223(19)36684-x
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: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 10476 d)
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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