Dear Colleagues,

Surgical management of atrial fibrillation (AF) is indicated in patients undergoing a concomitant cardiac surgery and in those who were not successfully treated by catheter ablation. Closure of the left atrial (LA) appendage with or without AF ablation is performed to prevent thromboembolic complications of AF. Indication of each procedure has been discussed based on the evidence of postoperative outcome and other patient conditions.

The rationale behind the termination and prevention of AF is the creation of a conduction block on the atrial tissue, which was initially achieved by a cut-and-sew technique and later replaced by thermal ablation with various energy sources and technologies. More recently a non-thermal ablation technique has been introduced, and clinical results are awaited.

A conduction block cannot be verified visually, and thus residual conduction due to incomplete ablation can occur with recurrence of AF or development of atrial tachycardia. Pitfalls in surgical techniques should be stressed and widely recognized.

As in the other surgical procedures, minimally invasive or robotic procedures have now been adopted. Meanwhile, LA appendage management has been performed with thoracoscopy. Advancement of technology and technique in these procedures should be discussed.

We invite papers on the following topics:

• Indication of surgical ablation and LA appendage closure
• New energy sources and technologies in ablation
• Keys to successful ablation
• Minimally invasive or robotic ablation
• Recent progress in LA appendage management
• Others

Prof. Takashi Nitta
Guest Editor