Research progress of Maze procedure treating atrial fibrillation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CHEN Cheng ^1,2,3 ,  CHEN Hao ^1,2,3

1. Chongqing Medical University, Chongqing, 400016, P. R. China;
2. Chongqing Institutes of Green and Intelligent Technology, Chongqing, 400714, P. R. China;
3. Department of Cardiovascular Surgery, Chongqing General Hospital, Chongqing Academy of Medical Sciences, Chongqing, 401147, P. R. China;

Corresponding?author：

CHEN Hao, Email: dr.chenhao@qq.com

Keywords：

Atrial fibrillation; Maze procedure; Cox-Maze Ⅳ procedure; hybrid approach; review

DOI：

10.7507/1007-4848.202308020

Video：

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Abstract Full text Figures/Tables Video References Cited by

Atrial fibrillation (AF) is the most common cardiac arrhythmia and is known to be associated with stroke, dementia, heart failure, and increased mortality. For patients with drug-refractory AF, ablation therapy using surgical or catheter-based techniques is recommended. In the evolution of surgical AF treatment, the Maze Ⅲ procedure marked a significant milestone as the first surgical approach to achieve a high success rate in restoring sinus rhythm. However, due to its technical complexity and demanding requirements, researchers have extensively modified the technique using innovative approaches, leading to the development of new surgical ablation methods, including the Maze Ⅳ procedure, minimally invasive Maze Ⅳ surgery, and hybrid ablation techniques. This review focuses on these surgical treatment strategies and discusses the latest research advancements in the field.

Citation： CHEN Cheng, CHEN Hao. Research progress of Maze procedure treating atrial fibrillation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2025, 32(7): 1036-1043. doi: 10.7507/1007-4848.202308020 Copy

1.	Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the Diagnosis and Management of Atrial Fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J, 2021, 42(5): 373-498.
2.	Tan S, Zhou J, Veang T, et al. Global, regional, and national burden of atrial fibrillation and atrial flutter from 1990 to 2021: Sex differences and global burden projections to 2046: A systematic analysis of the Global Burden of Disease Study 2021. Europace, 2025, 27(2): euaf027.
3.	Shi S, Tang Y, Zhao Q, et al. Prevalence and risk of atrial fibrillation in China: A national cross-sectional epidemiological study. Lancet Reg Health West Pac, 2022, 23: 100439.
4.	中華醫學會心電生理和起搏分會, 中國醫師協會心律學專業委員會, 中國房顫中心聯盟心房顫動防治專家工作委員會. 心房顫動: 目前的認識和治療建議(2021). 中華心律失常學雜志, 2022, 26(1): 15-88.Chinese Society of Pacing and Electrophysiology, Chinese Society of Arrhythmias, Atrial Fibrillation Center Union of China. Current knowledge and management of atrial fibrillation: Consensus of Chinese experts 2021. Chin J Cardiac Arrhyth, 2022, 26(1): 15-88.
5.	史寶燕, 孫洪勝, 李玥, 等. 心房顫動的機制與代謝組學研究. 中國比較醫學雜志, 2022, 32(5): 128-131, 137.Shi BY, Sun HS, Li Y, et al. Mechanism and metabonomics of atrial fibrillation. Chin J Comp Med, 2022, 32(5): 128-131, 137.
6.	Sagris M, Vardas EP, Theofilis P, et al. Atrial fibrillation: Pathogenesis, predisposing factors, and genetics. Int J Mol Sci, 2021, 23(1): 6.
7.	Cox JL. The surgical treatment of atrial fibrillation. J Thorac Cardiovasc Surg 1991, 101(4): 584-592.
8.	Cox JL, Boineau JP, Schuessler RB, et al. Modification of the maze procedure for atrial flutter and atrial fibrillation. Ⅰ. Rationale and surgical results. J Thorac Cardiovasc Surg, 1995, 110(2): 473-484.
9.	Cox JL, Schuessler RB, Lappas DG, et al. An 8 1/2-year clinical experience with surgery for atrial fibrillation. Ann Surg, 1996, 224(3): 267-273.
10.	宋金田. 迷宮Ⅲ型手術治療結構性心臟病合并心房顫動的臨床研究. 南方醫科大學, 2019.Song JT. Cox-maze Ⅲ procedure for structural heart disease associated with atrial fibrillation. Southern Medical University, 2019.
11.	Cox JL, Jaquiss RD, Schuessler RB, et al. Modification of the maze procedure for atrial flutter and atrial fibrillation. Ⅱ. Surgical technique of the maze Ⅲ procedure. J Thorac Cardiovasc Surg, 1995, 110(2): 485-495.
12.	Cox JL, Schuessler RB, Boineau JP. The development of the Maze procedure for the treatment of atrial fibrillation. Semin Thorac Cardiovasc Surg, 2000, 12(1): 2-14.
13.	McCarthy PM, Gillinov AM, Castle L, et al. The Cox-Maze procedure: The cleveland clinic experience. Semin Thorac Cardiovasc Surg, 2000, 12(1): 25-29.
14.	Schaff HV, Dearani JA, Daly RC, et al. Cox-Maze procedure for atrial fibrillation: Mayo Clinic experience. Semin Thorac Cardiovasc Surg, 2000, 12(1): 30-37.
15.	謝賽旗, 王輝山, 韓勁松, 等. 機械瓣膜或生物瓣膜置換及經典迷宮Ⅲ型手術治療心房顫動合并巨大左心房和風濕性二尖瓣病變. 中國組織工程研究, 2019, 23(26): 4187-4193.Xie SQ, Wang HS, Han JS, et al. Cut-and-sew maze procedure and mitral valve replacement in the treatment of atrial fibrillation associated with giant left atrium and rheumatic mitral valve disease. Chin J Tissue Eng Res, 2019, 23(26): 4187-4193.
16.	García-Villarreal OA. Efectividad del procedimiento de Cox-maze Ⅲ a largo plazo y su relación con el tama?o posoperatorio de la aurícula izquierda. Gac Med Mex, 2019, 155(6): 590-595.
17.	Atik FA, Gomes GG, Rodrigues FF, et al. Is it conceivable to still perform the cut and sew Cox MazeⅢprocedure in the current era? Semin Thorac Cardiovasc Surg, 2018, 30(4): 429-436.
18.	Wang CT, Zhang L, Qin T, et al. Cox-mazeⅢprocedure for atrial fibrillation during valve surgery: A single institution experience. J Cardiothorac Surg, 2020, 15(1): 111.
19.	Cox JL, Churyla A, Malaisrie SC, et al. When is a Maze procedure a Maze procedure? Can J Cardiol, 2018, 34(11): 1482-1491.
20.	Kaba RA, Ahmed O, Behr E, et al. A chronicle of hybrid atrial fibrillation ablation therapy: From Cox Maze to convergent. Arrhythm Electrophysiol Rev, 2022, 11: e12.
21.	McCarthy PM, Gerdisch M, Philpott J, et al. Three-year outcomes of the postapproval study of the AtriCure bipolar radiofrequency ablation of permanent atrial fibrillation trial. J Thorac Cardiovasc Surg, 2022, 164(2): 519-527.
22.	MacGregor RM, Melby SJ, Schuessler RB, et al. Energy sources for the surgical treatment of atrial fibrillation. Innovations (Phila), 2019, 14(6): 503-508.
23.	Phan K, Xie A, Kumar N, et al. Comparing energy sources for surgical ablation of atrial fibrillation: A Bayesian network meta-analysis of randomized, controlled trials. Eur J Cardiothorac Surg, 2015, 48(2): 201-211.
24.	Reyes G, Ruyra X, Valderrama F, et al. High intensity focused ultrasound ablation for atrial fibrillation: Results from the National Spanish Registry. Minerva Cardioangiol, 2016, 64(5): 501-506.
25.	Gerdisch M, Lehr E, Dunnington G, et al. Mid-term outcomes of concomitant Cox-MazeⅣ: Results from a multicenter prospective registry. J Card Surg, 2022, 37(10): 3006-3013.
26.	Fran?ois J, Claus I, Cathenis K, et al. Ten year experience with the concomitant Maze Ⅳ procedure for atrial fibrillation. Acta Chir Belg, 2022, 122(2): 99-106.
27.	Iribarne A, DiScipio AW, McCullough JN, et al. Surgical atrial fibrillation ablation improves long-term survival: A multicenter analysis. Ann Thorac Surg, 2019, 107(1): 135-142.
28.	Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2022, 43(7): 561-632.
29.	Lancaster TS, Melby SJ, Damiano RJ. Minimally invasive surgery for atrial fibrillation. Trends Cardiovasc Med, 2016, 26(3): 268-277.
30.	Wolf RK, Schneeberger EW, Osterday R, et al. Video-assisted bilateral pulmonary vein isolation and left atrial appendage exclusion for atrial fibrillation. J Thorac Cardiovasc Surg, 2005, 130(3): 797-802.
31.	Wolf RK. Minimally invasive surgical treatment of atrial fibrillation. Semin Thorac Cardiovasc Surg, 2007, 19(4): 311-318.
32.	Shemin RJ. Counterpoint: Minimally invasive bipolar radiofrequency ablation of lone atrial fibrillation: Early multicenter results. J Thorac Cardiovasc Surg, 2009, 137(3): 527-528.
33.	Zheng S, Li Y, Han J, et al. Long-term results of a minimally invasive surgical pulmonary vein isolation and ganglionic plexi ablation for atrial fibrillation. PLoS One, 2013, 8(11): e79755.
34.	馬南, 姜兆磊, 陳飛, 等. 梅氏微創消融術治療心房顫動207例. 中國胸心血管外科臨床雜志, 2015, 22(11): 996-999.Ma N, Jiang ZL, Chen F, et al. Mei mini maze procedure for 207 patients with atrial fibrillation. Chin J Clin Thorac Cardiovasc Surg, 2015, 22(11): 996-999.
35.	馬南, 梅舉, 盧榮鑫, 等. 梅氏微創消融術治療導管消融失敗心房顫動患者的臨床結果. 中華心血管病雜志, 2018, 46(8): 601-605.Ma N, Mei J, Lu RX, et al. Clinical results of Mei mini maze procedure for atrial fibrillation patients with previously failed catheter ablation. Chin J Cardiol, 2018, 46(8): 601-605.
36.	Ruaengsri C, Schill MR, Khiabani AJ, et al. The Cox-maze Ⅳ procedure in its second decade: Still the gold standard? Eur J Cardiothorac Surg, 2018, 53(suppl_1): i19-i25.
37.	Sef D, Trkulja V, Raja SG, et al. Comparing mid-term outcomes of Cox-Maze procedure and pulmonary vein isolation for atrial fibrillation after concomitant mitral valve surgery: A systematic review. J Card Surg, 2022, 37(11): 3801-3810.
38.	Ad N, Holmes SD, Friehling T. Minimally invasive stand-alone Cox Maze procedure for persistent and long-standing persistent atrial fibrillation: Perioperative safety and 5-year outcomes. Circ Arrhythm Electrophysiol, 2017, 10(11): e005352.
39.	MacGregor RM, Bakir NH, Pedamallu H, et al. Late results after stand-alone surgical ablation for atrial fibrillation. J Thorac Cardiovasc Surg, 2022, 164(5): 1515-1528.
40.	Jiang Z, Tang M, Ma N, et al. Right minithoracotomy versus conventional median sternotomy for patients undergoing mitral valve surgery and Cox-maze Ⅳ ablation with entirely bipolar radiofrequency clamp. Heart Vessels, 2018, 33(8): 901-907.
41.	Cox JL, Malaisrie SC, Churyla A, et al. Cryosurgery for atrial fibrillation: Physiologic basis for creating optimal cryolesions. Ann Thorac Surg, 2021, 112(2): 354-362.
42.	Bogachev-Prokophiev A, Sharifulin R, Karadzha A, et al. Results of concomitant cryoablation for atrial fibrillation during mitral valve surgery. Interact Cardiovasc Thorac Surg, 2022, 34(4): 540-547.
43.	Han J, Wang H, Wang Z, et al. Comparison of CryoMaze with cut-and-sew Maze concomitant with mitral valve surgery: A randomized noninferiority trial. Semin Thorac Cardiovasc Surg, 2021, 33(3): 680-688.
44.	Okada M, Usui A, Sakurai T, et al. Comparative study between cryoablation and radiofrequency ablation for surgical intervention of atrial fibrillation associated with mitral valve disease. Kyobu Geka, 2010, 63(4): 297-302.
45.	Vural ü, Balc? AY, A?lar AA, et al. Which method to use for surgical ablation of atrial fibrillation performed concomitantly with mitral valve surgery: Radiofrequency ablation versus cryoablation. Braz J Cardiovasc Surg, 2018, 33(6): 542-552.
46.	Razzack AA, Lak HM, Pothuru S, et al. Efficacy and safety of catheter ablation vs. antiarrhythmic drugs as initial therapy for management of symptomatic paroxysmal atrial fibrillation: A meta-analysis. Rev Cardiovasc Med, 2022, 23(3): 112.
47.	Kuniss M, Pavlovic N, Velagic V, et al. Cryoballoon ablation vs. antiarrhythmic drugs: First-line therapy for patients with paroxysmal atrial fibrillation. Europace, 2021, 23(7): 1033-1041.
48.	Turagam MK, Musikantow D, Whang W, et al. Assessment of catheter ablation or antiarrhythmic drugs for first-line therapy of atrial fibrillation: A meta-analysis of randomized clinical trials. JAMA Cardiol, 2021, 6(6): 697-705.
49.	Rattanawong P, Kanitsoraphan C, Kewcharoen J, et al. Surgical versus catheter ablation in atrial fibrillation: A systematic review and meta-analysis of randomized controlled trials. J Cardiovasc Electrophysiol, 2022, 33(10): 2152-2163.
50.	Varzaly JA, Lau DH, Chapman D, et al. Hybrid ablation for atrial fibrillation: A systematic review and meta-analysis. JTCVS Open, 2021, 7: 141-154.
51.	van der Heijden CAJ, Vroomen M, Luermans JG, et al. Hybrid versus catheter ablation in patients with persistent and longstanding persistent atrial fibrillation: A systematic review and meta-analysis. Eur J Cardiothorac Surg, 2019, 56(3): 433-443.
52.	DeLurgio DB, Crossen KJ, Gill J, et al. Hybrid convergent procedure for the treatment of persistent and long-standing persistent atrial fibrillation: Results of CONVERGE clinical trial. Circ Arrhythm Electrophysiol, 2020, 13(12): e009288.
53.	Magni FT, Al-Jazairi MIH, Mulder BA, et al. First-line treatment of persistent and long-standing persistent atrial fibrillation with single-stage hybrid ablation: A 2-year follow-up study. Europace, 2021, 23(10): 1568-1576.
54.	張俊杰. 采用雜交消融對比單純內外科消融治療房顫的Meta分析. 南京醫科大學, 2018.Zhang JJ. Hybrid ablation versus minimally invasive surgical or transcatheter meta-analysis. Nanjing Medical University, 2018.
55.	La Meir M, Gelsomino S, Lucà F, et al. Minimally invasive surgical treatment of lone atrial fibrillation: Early results of hybrid versus standard minimally invasive approach employing radiofrequency sources. Int J Cardiol, 2013, 167(4): 1469-1475.

1. Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the Diagnosis and Management of Atrial Fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J, 2021, 42(5): 373-498.
2. Tan S, Zhou J, Veang T, et al. Global, regional, and national burden of atrial fibrillation and atrial flutter from 1990 to 2021: Sex differences and global burden projections to 2046: A systematic analysis of the Global Burden of Disease Study 2021. Europace, 2025, 27(2): euaf027.
3. Shi S, Tang Y, Zhao Q, et al. Prevalence and risk of atrial fibrillation in China: A national cross-sectional epidemiological study. Lancet Reg Health West Pac, 2022, 23: 100439.
4. 中華醫學會心電生理和起搏分會, 中國醫師協會心律學專業委員會, 中國房顫中心聯盟心房顫動防治專家工作委員會. 心房顫動: 目前的認識和治療建議(2021). 中華心律失常學雜志, 2022, 26(1): 15-88.Chinese Society of Pacing and Electrophysiology, Chinese Society of Arrhythmias, Atrial Fibrillation Center Union of China. Current knowledge and management of atrial fibrillation: Consensus of Chinese experts 2021. Chin J Cardiac Arrhyth, 2022, 26(1): 15-88.
5. 史寶燕, 孫洪勝, 李玥, 等. 心房顫動的機制與代謝組學研究. 中國比較醫學雜志, 2022, 32(5): 128-131, 137.Shi BY, Sun HS, Li Y, et al. Mechanism and metabonomics of atrial fibrillation. Chin J Comp Med, 2022, 32(5): 128-131, 137.
6. Sagris M, Vardas EP, Theofilis P, et al. Atrial fibrillation: Pathogenesis, predisposing factors, and genetics. Int J Mol Sci, 2021, 23(1): 6.
7. Cox JL. The surgical treatment of atrial fibrillation. J Thorac Cardiovasc Surg 1991, 101(4): 584-592.
8. Cox JL, Boineau JP, Schuessler RB, et al. Modification of the maze procedure for atrial flutter and atrial fibrillation. Ⅰ. Rationale and surgical results. J Thorac Cardiovasc Surg, 1995, 110(2): 473-484.
9. Cox JL, Schuessler RB, Lappas DG, et al. An 8 1/2-year clinical experience with surgery for atrial fibrillation. Ann Surg, 1996, 224(3): 267-273.
10. 宋金田. 迷宮Ⅲ型手術治療結構性心臟病合并心房顫動的臨床研究. 南方醫科大學, 2019.Song JT. Cox-maze Ⅲ procedure for structural heart disease associated with atrial fibrillation. Southern Medical University, 2019.
11. Cox JL, Jaquiss RD, Schuessler RB, et al. Modification of the maze procedure for atrial flutter and atrial fibrillation. Ⅱ. Surgical technique of the maze Ⅲ procedure. J Thorac Cardiovasc Surg, 1995, 110(2): 485-495.
12. Cox JL, Schuessler RB, Boineau JP. The development of the Maze procedure for the treatment of atrial fibrillation. Semin Thorac Cardiovasc Surg, 2000, 12(1): 2-14.
13. McCarthy PM, Gillinov AM, Castle L, et al. The Cox-Maze procedure: The cleveland clinic experience. Semin Thorac Cardiovasc Surg, 2000, 12(1): 25-29.
14. Schaff HV, Dearani JA, Daly RC, et al. Cox-Maze procedure for atrial fibrillation: Mayo Clinic experience. Semin Thorac Cardiovasc Surg, 2000, 12(1): 30-37.
15. 謝賽旗, 王輝山, 韓勁松, 等. 機械瓣膜或生物瓣膜置換及經典迷宮Ⅲ型手術治療心房顫動合并巨大左心房和風濕性二尖瓣病變. 中國組織工程研究, 2019, 23(26): 4187-4193.Xie SQ, Wang HS, Han JS, et al. Cut-and-sew maze procedure and mitral valve replacement in the treatment of atrial fibrillation associated with giant left atrium and rheumatic mitral valve disease. Chin J Tissue Eng Res, 2019, 23(26): 4187-4193.
16. García-Villarreal OA. Efectividad del procedimiento de Cox-maze Ⅲ a largo plazo y su relación con el tama?o posoperatorio de la aurícula izquierda. Gac Med Mex, 2019, 155(6): 590-595.
17. Atik FA, Gomes GG, Rodrigues FF, et al. Is it conceivable to still perform the cut and sew Cox MazeⅢprocedure in the current era? Semin Thorac Cardiovasc Surg, 2018, 30(4): 429-436.
18. Wang CT, Zhang L, Qin T, et al. Cox-mazeⅢprocedure for atrial fibrillation during valve surgery: A single institution experience. J Cardiothorac Surg, 2020, 15(1): 111.
19. Cox JL, Churyla A, Malaisrie SC, et al. When is a Maze procedure a Maze procedure? Can J Cardiol, 2018, 34(11): 1482-1491.
20. Kaba RA, Ahmed O, Behr E, et al. A chronicle of hybrid atrial fibrillation ablation therapy: From Cox Maze to convergent. Arrhythm Electrophysiol Rev, 2022, 11: e12.
21. McCarthy PM, Gerdisch M, Philpott J, et al. Three-year outcomes of the postapproval study of the AtriCure bipolar radiofrequency ablation of permanent atrial fibrillation trial. J Thorac Cardiovasc Surg, 2022, 164(2): 519-527.
22. MacGregor RM, Melby SJ, Schuessler RB, et al. Energy sources for the surgical treatment of atrial fibrillation. Innovations (Phila), 2019, 14(6): 503-508.
23. Phan K, Xie A, Kumar N, et al. Comparing energy sources for surgical ablation of atrial fibrillation: A Bayesian network meta-analysis of randomized, controlled trials. Eur J Cardiothorac Surg, 2015, 48(2): 201-211.
24. Reyes G, Ruyra X, Valderrama F, et al. High intensity focused ultrasound ablation for atrial fibrillation: Results from the National Spanish Registry. Minerva Cardioangiol, 2016, 64(5): 501-506.
25. Gerdisch M, Lehr E, Dunnington G, et al. Mid-term outcomes of concomitant Cox-MazeⅣ: Results from a multicenter prospective registry. J Card Surg, 2022, 37(10): 3006-3013.
26. Fran?ois J, Claus I, Cathenis K, et al. Ten year experience with the concomitant Maze Ⅳ procedure for atrial fibrillation. Acta Chir Belg, 2022, 122(2): 99-106.
27. Iribarne A, DiScipio AW, McCullough JN, et al. Surgical atrial fibrillation ablation improves long-term survival: A multicenter analysis. Ann Thorac Surg, 2019, 107(1): 135-142.
28. Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2022, 43(7): 561-632.
29. Lancaster TS, Melby SJ, Damiano RJ. Minimally invasive surgery for atrial fibrillation. Trends Cardiovasc Med, 2016, 26(3): 268-277.
30. Wolf RK, Schneeberger EW, Osterday R, et al. Video-assisted bilateral pulmonary vein isolation and left atrial appendage exclusion for atrial fibrillation. J Thorac Cardiovasc Surg, 2005, 130(3): 797-802.
31. Wolf RK. Minimally invasive surgical treatment of atrial fibrillation. Semin Thorac Cardiovasc Surg, 2007, 19(4): 311-318.
32. Shemin RJ. Counterpoint: Minimally invasive bipolar radiofrequency ablation of lone atrial fibrillation: Early multicenter results. J Thorac Cardiovasc Surg, 2009, 137(3): 527-528.
33. Zheng S, Li Y, Han J, et al. Long-term results of a minimally invasive surgical pulmonary vein isolation and ganglionic plexi ablation for atrial fibrillation. PLoS One, 2013, 8(11): e79755.
34. 馬南, 姜兆磊, 陳飛, 等. 梅氏微創消融術治療心房顫動207例. 中國胸心血管外科臨床雜志, 2015, 22(11): 996-999.Ma N, Jiang ZL, Chen F, et al. Mei mini maze procedure for 207 patients with atrial fibrillation. Chin J Clin Thorac Cardiovasc Surg, 2015, 22(11): 996-999.
35. 馬南, 梅舉, 盧榮鑫, 等. 梅氏微創消融術治療導管消融失敗心房顫動患者的臨床結果. 中華心血管病雜志, 2018, 46(8): 601-605.Ma N, Mei J, Lu RX, et al. Clinical results of Mei mini maze procedure for atrial fibrillation patients with previously failed catheter ablation. Chin J Cardiol, 2018, 46(8): 601-605.
36. Ruaengsri C, Schill MR, Khiabani AJ, et al. The Cox-maze Ⅳ procedure in its second decade: Still the gold standard? Eur J Cardiothorac Surg, 2018, 53(suppl_1): i19-i25.
37. Sef D, Trkulja V, Raja SG, et al. Comparing mid-term outcomes of Cox-Maze procedure and pulmonary vein isolation for atrial fibrillation after concomitant mitral valve surgery: A systematic review. J Card Surg, 2022, 37(11): 3801-3810.
38. Ad N, Holmes SD, Friehling T. Minimally invasive stand-alone Cox Maze procedure for persistent and long-standing persistent atrial fibrillation: Perioperative safety and 5-year outcomes. Circ Arrhythm Electrophysiol, 2017, 10(11): e005352.
39. MacGregor RM, Bakir NH, Pedamallu H, et al. Late results after stand-alone surgical ablation for atrial fibrillation. J Thorac Cardiovasc Surg, 2022, 164(5): 1515-1528.
40. Jiang Z, Tang M, Ma N, et al. Right minithoracotomy versus conventional median sternotomy for patients undergoing mitral valve surgery and Cox-maze Ⅳ ablation with entirely bipolar radiofrequency clamp. Heart Vessels, 2018, 33(8): 901-907.
41. Cox JL, Malaisrie SC, Churyla A, et al. Cryosurgery for atrial fibrillation: Physiologic basis for creating optimal cryolesions. Ann Thorac Surg, 2021, 112(2): 354-362.
42. Bogachev-Prokophiev A, Sharifulin R, Karadzha A, et al. Results of concomitant cryoablation for atrial fibrillation during mitral valve surgery. Interact Cardiovasc Thorac Surg, 2022, 34(4): 540-547.
43. Han J, Wang H, Wang Z, et al. Comparison of CryoMaze with cut-and-sew Maze concomitant with mitral valve surgery: A randomized noninferiority trial. Semin Thorac Cardiovasc Surg, 2021, 33(3): 680-688.
44. Okada M, Usui A, Sakurai T, et al. Comparative study between cryoablation and radiofrequency ablation for surgical intervention of atrial fibrillation associated with mitral valve disease. Kyobu Geka, 2010, 63(4): 297-302.
45. Vural ü, Balc? AY, A?lar AA, et al. Which method to use for surgical ablation of atrial fibrillation performed concomitantly with mitral valve surgery: Radiofrequency ablation versus cryoablation. Braz J Cardiovasc Surg, 2018, 33(6): 542-552.
46. Razzack AA, Lak HM, Pothuru S, et al. Efficacy and safety of catheter ablation vs. antiarrhythmic drugs as initial therapy for management of symptomatic paroxysmal atrial fibrillation: A meta-analysis. Rev Cardiovasc Med, 2022, 23(3): 112.
47. Kuniss M, Pavlovic N, Velagic V, et al. Cryoballoon ablation vs. antiarrhythmic drugs: First-line therapy for patients with paroxysmal atrial fibrillation. Europace, 2021, 23(7): 1033-1041.
48. Turagam MK, Musikantow D, Whang W, et al. Assessment of catheter ablation or antiarrhythmic drugs for first-line therapy of atrial fibrillation: A meta-analysis of randomized clinical trials. JAMA Cardiol, 2021, 6(6): 697-705.
49. Rattanawong P, Kanitsoraphan C, Kewcharoen J, et al. Surgical versus catheter ablation in atrial fibrillation: A systematic review and meta-analysis of randomized controlled trials. J Cardiovasc Electrophysiol, 2022, 33(10): 2152-2163.
50. Varzaly JA, Lau DH, Chapman D, et al. Hybrid ablation for atrial fibrillation: A systematic review and meta-analysis. JTCVS Open, 2021, 7: 141-154.
51. van der Heijden CAJ, Vroomen M, Luermans JG, et al. Hybrid versus catheter ablation in patients with persistent and longstanding persistent atrial fibrillation: A systematic review and meta-analysis. Eur J Cardiothorac Surg, 2019, 56(3): 433-443.
52. DeLurgio DB, Crossen KJ, Gill J, et al. Hybrid convergent procedure for the treatment of persistent and long-standing persistent atrial fibrillation: Results of CONVERGE clinical trial. Circ Arrhythm Electrophysiol, 2020, 13(12): e009288.
53. Magni FT, Al-Jazairi MIH, Mulder BA, et al. First-line treatment of persistent and long-standing persistent atrial fibrillation with single-stage hybrid ablation: A 2-year follow-up study. Europace, 2021, 23(10): 1568-1576.
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Research progress of Maze procedure treating atrial fibrillation

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