- 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;
CHEN Hao,
Email: dr.chenhao@qq.com
Atrial fibrillation is the most common arrhythmia and is known to be in connection with stroke, dementia, heart failure and increased risk of death. For drug-refractory atrial fibrillation, surgical or catheter ablation is recommended. Early attempts to design procedures to ablate atrial fibrillation and restore sinus rhythm culminated in the Cox-Maze Ⅲ procedure, which was the first truly successful procedure. However, Cox-Maze Ⅲ procedure is complex and technically demanding, so it has been extensively modified with new techniques to create new types of surgical ablation procedures: Cox-Maze Ⅳ procedure, minimally invasive Cox-Maze Ⅳ procedure, and the latest “hybrid approach”. This review mainly discusses these surgical treatment strategies and the latest research progress.
Copyright © the editorial department of Chinese Journal of Clinical Thoracic and Cardiovascular Surgery of West China Medical Publisher. All rights reserved
| 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. | Roth GA, Mensah GA, Johnson CO, et al. Global burden of cardiovascular diseases and risk factors, 1990-2019: Update from the GBD 2019 study. J Am Coll Cardiol, 2020, 76(25): 2982-3021. |
| 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. | 中华医学会心电生理和起搏分会, 中国医师协会心律学专业委员会, 中国房颤中心联盟心房颤动防治专家工作委员会. 心房颤动: 目前的认识和治疗建议(2021). 中华心律失常学杂志, 2022, 26(1): 15-88. |
| 5. | 史宝燕, 孙洪胜, 李玥, 等. 心房颤动的机制与代谢组学研究. 中国比较医学杂志, 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. 迷宫Ⅲ型手术治疗结构性心脏病合并心房颤动的临床研究. 南方医科大学, 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. | 谢赛旗, 王辉山, 韩劲松, 等. 机械瓣膜或生物瓣膜置换及经典迷宫Ⅲ型手术治疗心房颤动合并巨大左心房和风湿性二尖瓣病变. 中国组织工程研究, 2019, 23(26): 4187-4193. |
| 16. | García-Villarreal OA. Efectividad del procedimiento de Cox-maze III a largo plazo y su relación con el tamaño 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 Maze III procedure in the current era?. Semin Thorac Cardiovasc Surg, 2018, 30(4): 429-436. |
| 18. | Wang CT, Zhang L, Qin T, et al. Cox-maze III procedure 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-Maze IV: Results from a multicenter prospective registry. J Card Surg, 2022, 37(10): 3006-3013. |
| 26. | François 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. | 马南, 姜兆磊, 陈飞, 等. 梅氏微创消融术治疗心房颤动207例. 中国胸心血管外科临床杂志, 2015, 22(11): 996-999. |
| 35. | 马南, 梅举, 卢荣鑫, 等. 梅氏微创消融术治疗导管消融失败心房颤动患者的临床结果. 中华心血管病杂志, 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, Autumn,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, Balcı AY, Ağlar 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. | 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. |
| 52. | 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. |
| 53. | 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. |
| 54. | 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. |
| 55. | 张俊杰. 采用杂交消融对比单纯内外科消融治疗房颤的Meta分析. 南京医科大学, 2018. |
| 56. | 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. Roth GA, Mensah GA, Johnson CO, et al. Global burden of cardiovascular diseases and risk factors, 1990-2019: Update from the GBD 2019 study. J Am Coll Cardiol, 2020, 76(25): 2982-3021.
- 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. 中华医学会心电生理和起搏分会, 中国医师协会心律学专业委员会, 中国房颤中心联盟心房颤动防治专家工作委员会. 心房颤动: 目前的认识和治疗建议(2021). 中华心律失常学杂志, 2022, 26(1): 15-88.
- 5. 史宝燕, 孙洪胜, 李玥, 等. 心房颤动的机制与代谢组学研究. 中国比较医学杂志, 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. 迷宫Ⅲ型手术治疗结构性心脏病合并心房颤动的临床研究. 南方医科大学, 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. 谢赛旗, 王辉山, 韩劲松, 等. 机械瓣膜或生物瓣膜置换及经典迷宫Ⅲ型手术治疗心房颤动合并巨大左心房和风湿性二尖瓣病变. 中国组织工程研究, 2019, 23(26): 4187-4193.
- 16. García-Villarreal OA. Efectividad del procedimiento de Cox-maze III a largo plazo y su relación con el tamaño 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 Maze III procedure in the current era?. Semin Thorac Cardiovasc Surg, 2018, 30(4): 429-436.
- 18. Wang CT, Zhang L, Qin T, et al. Cox-maze III procedure 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-Maze IV: Results from a multicenter prospective registry. J Card Surg, 2022, 37(10): 3006-3013.
- 26. François 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. 马南, 姜兆磊, 陈飞, 等. 梅氏微创消融术治疗心房颤动207例. 中国胸心血管外科临床杂志, 2015, 22(11): 996-999.
- 35. 马南, 梅举, 卢荣鑫, 等. 梅氏微创消融术治疗导管消融失败心房颤动患者的临床结果. 中华心血管病杂志, 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, Autumn,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, Balcı AY, Ağlar 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. 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.
- 52. 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.
- 53. 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.
- 54. 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.
- 55. 张俊杰. 采用杂交消融对比单纯内外科消融治疗房颤的Meta分析. 南京医科大学, 2018.
- 56. 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.