Interim Results of the 5-Box Thoracoscopic Maze Procedure

In accordance with the Cox-Maze paradigm, successful treatment of atrial fibrillation (AF) requires (1) complete posterior left atrial isolation, (2) elimination of corridors for perimitral reentry, (3) elimination of cardiac venous (superior vena cava and coronary sinus) arrhythmogenic foci, (4) complete autonomic denervation, and (5) occlusion or removal of the left atrial appendage. Using a totally thoracoscopic approach, isolation of all left atrial arrhythmogenic substrate is achieved through the creation of 5 discrete but contiguous compartments, thereby enabling unambiguous verification with bidirectional block. Since no previous closed-chest procedure incorporates all these end points, an update on patient outcomes is reported