What is essential for the elimination of persistent or chronic atrial fibrillation?

Dr. James Cox devised the maze procedure as a radical intervention for lone atrial fibrillation (AF) based on the multiple reentry theory. Dr. Micheal Haissaguerre discovered ectopic foci from the pulmonary veins were the trigger for paroxysmal AF. We demonstrated the efficacy of the pulmonary vein box isolation procedure for chronic AF. Dr. Koonlfawee Nademanee reported the complex fractionated atrial electrogram (CFAE) procedure to eliminate the substrate of chronic AF, which is distributed around the pulmonary veins. The complete isolation of all pulmonary veins is essential for the elimination of AF.