Surgical therapy for atrial fibrillation.

Atrial fibrillation is the most common sustained rhythm other than sinus rhythm encountered in clinical practice. There are three detrimental sequelae to the rhythm of atrial fibrillation, although the relative magnitude of the detriment varies from patient to patient. These include the sensation of the irregular heart beat, the hemodynamic compromise that is associated with the loss of atrial transport function, and the third is the risk of thromboembolism. Twelve years of experimental and clinical investigation have resulted in the development of a surgical procedure to cure patients with both paroxysmal and chronic atrial fibrillation, as well as atrial flutter. The operation is successful in restoring all patients to sinus rhythm, restoring atrial transport function, and in preventing the recurrence of atrial fibrillation. This procedure is becoming the treatment of choice in patients with drug-refractory, symptomatic atrial fibrillation.