Epicardial ablation of atrial fibrillation on the beating heart without cardiopulmonary bypass

The Cox-Maze procedure is the gold standard in surgical treatment of atrial fibrillation. Alternative techniques using cryoablation, radiofrequency, or microwaves have been proven to be equally effective. However, up to now, all techniques require the opening of the atria and, hence, the use of extracorporeal circulation. We describe a technique to perform epicardial ablation of atrial fibrillation on the beating heart without the use of cardiopulmonary bypass.