Minimally invasive surgical atrial fibrillation ablation: Patient selection and results

Minimally invasive surgical atrial fibrillation ablation (MISAA) is an emerging alternative to catheter ablation and the full surgical maze procedure for nonpharmacologic treatment of atrial fibrillation. MISAA offers the potential to provide highly effective pulmonary vein isolation, exclusion of the left atrial appendage, and extensive ablation of the ganglionic plexuses and the ligament of Marshall in a single procedure. We review the safety and efficacy of MISAA, discuss considerations for optimal patient selection for MISAA, and review the advantages/disadvantages of MISAA compared with catheter ablation and the maze procedure.