Abstract

Atrial fibrillation (AF) is a prevalent cardiac arrhythmia that increases the risk of stroke and heart failure. Surgical interventions such as the Cox-Maze IV, Cryo-Maze, and Electrocautery Maze procedures are effective in restoring sinus rhythm by creating conduction blocks in the atria. This review compares these procedures, highlighting their mechanisms, clinical outcomes, and advantages. Cox-Maze IV, utilizing radiofrequency or cryoablation, is the most widely adopted and effective, offering up to 90%success in long-term rhythm control. Cryo-Maze is less invasive and offers precise lesion formation, while Electrocautery Maze is a less commonly used but effective option for patients undergoing open-heart surgery. Each procedure’s success is influenced by patient-specific factors, and the choice of technique depends on invasiveness and clinical context.