Randall K. Wolf  University of Cincinnati， USA

<International Circulation>: Compared with the catheter ablation therapy for the treatment of atrial fibrillation， what is the main superiority of the minimally invasive surgical ablation techniques?

Prof. Randall K. Wolf: There are several important differences between catheter ablation and minimally invasive surgical AF treatments. 1 With the surgical technique， we remove the left atrial appendage. By removing the left atrial appendage， we can decrease the risk of stroke， even if the patient has any atrial fibrillation after the procedure. 2 Since we create a transmural lesion， we treat not only the endocardium， but also the epicardium. This means we also interrupt the tiny nerves around the pulmonary veins; these autonomic fibers may play an important role in the atrial fibrillation. In the catheter technique， it is very difficult for them to interrupt the tiny nerves. 3 The cure rate for one procedure is much higher with the minimally invasive surgical technique. We have a high cure rate， a cure rate over 90%， and our first patient， now 5 years after the operation， remains cured and off all medications. So we have high cure rate， we remove left atrial appendage， and we interrupt some of the nerves around the pulmonary vein. Lastly， we have lower complication rate. In my own cases， we have no mortality and a very low complication rate.

<International Circulation>: How do you evaluate the efficacy and safety?

Prof. Randall K. Wolf: We monitor the patient at home. Once the patient is more than 6 months after the procedure， we utilize a home monitor. The patient wears the monitor continuously， usually for 7 days. The monitor is wireless， and can detect any rapid heart rates. We can determine if the patients have symptomatic or asymptomatic atrial fibrillation. As far as the safety is concerned， we did perform a follow up for 16 patients with MRI and CT scans. The scans were all normal after the operation. We have been following patients for 5 years， and there have been no long-term complications from the procedure.