Surgical Ablation Guidelines are Advancing
Cox Maze IV yields the highest efficacy for Afib treatment, but literature shows progressive
efficacy for each additive lesion set of Cox Maze IV
January, C. T., et al. (2019). 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for
the Management of Patients With Atrial Fibrillation: A Report of the American College of
Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart
Rhythm Society. Circulation, CIR-0000000000000665.
Badhwar, et al. (2017). The Society of Thoracic Surgeons 2017 Clinical Practice Guidelines for the
Surgical Treatment of Atrial Fibrillation. Ann Thorac Surg, 103(1):329-41.
January, C.T., et al. (2014). 2014 AHA/ACC/HRS guideline for the management of patients with atrial
fibrillation: a report of the American College of Cardiology/American Heart Association Task Force
on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol, 64(21):e1-76.
*Calkins, H., et al. (2017). 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter
and surgical ablation of atrial fibrillation. Heart Rhythm, 14(10):e275-444. AVR/CABG concomitant
ablation Class I LOR for symptomatic persistent and long-standing persistent “refractory or
intolerant to at least one Class 1 or 3 antiarrhythmic medication.”
Meier, B., et al. (2014). EHRA/EAPCI expert consensus statement on catheter-based left atrial
appendage occlusion. Europace, 16(10):1397-416.
Cox, J.L., et al. (1991). Dr. Cox performed first surgical ablation using maze I; Successful
surgical treatment of atrial fibrillation. Review and clinical update. JAMA, 266 (14):1976-80. COR :
Class of Recommendation LOE : Level of Evidence