Abstract
The fundamentals of effective surgical treatment for atrial fibrillation were established over 30 years ago with the development of the Cox-Maze operation. Restoration of atrioventricular synchrony, reduction of thromboembolic stroke risk, and symptom relief have always been the primary goals of therapy. Over time, surgical techniques and clinical considerations have significantly evolved, reaching a crescendo in the past decade. Herein, we highlight novel surgical workflows-specifically the Modified CryoMaze III, robotic-assisted Cox-Maze, non-atriotomy surgical ablation, and hybrid ablation. We also provide a focused discussion on atrial fibrillation-related dementia, tachycardia-induced heart failure, and updates in perioperative care.