Biatrial lesion sets.

The Cox-Maze procedure was developed more than 20 years ago at our institution. This traditional cut-and-sew operation had high success rates but was very invasive. To simplify this procedure, our group developed an operation, the Cox-Maze IV procedure, that replaces most of the incisions with linear lines of ablation while preserving the traditional biatrial lesion set. The technical aspects of the procedure are discussed in detail. Initial operative results with this new procedure have been good, with a freedom from atrial fibrillation of 90% at 1 year. The success rate is not significantly different from the traditional cut-and-sew procedure.