[Thoracoscopic Ex-Maze III procedure and radiofrequency catheter ablation - a hybrid therapy for permanent atrial fibrillation. A case report].

We desribe a case of a 57-year-old patient with persistent longstanding atrial fibrillation (AF) in whom paracardioscopic Ex-Maze III procedure converted AF to typical counterclockwise atrial flutter. Subsequent catheter RF ablation of cavo-tricuspid isthmus restored sinus rhythm. We propose that the hybrid therapy including thoracoscopic maze procedure and catheter RF ablation of flutter isthmus might be effective in some patients with permanent AF. To the best of our knowledge this approach was never published before. Lelako.