McCarthy PM, Gerdisch M, Philpott J, et al. - Given that the Cox Maze IV operation is frequently conducted concomitant with other cardiac operations and effectively attenuates the burden of atrial fibrillation, therefore, researchers investigated early as well as the midterm results of patients receiving the Cox Maze IV operation, as component of the postapproval process for a bipolar radiofrequency ablation system. A total of 363 patients (mean age, 70 years, 82% valve surgery) with nonparoxysmal atrial fibrillation receiving concomitant Maze IV atrial fibrillation ablation at 40 sites were analyzed in a prospective, multicenter, single-arm study. No device-related complications occurred. At 1, 2, and 3 years, freedom from atrial fibrillation off antiarrhythmic medications was reported to be 66%, 65%, and 64%, respectively. Overall, findings showed a high compliance with the protocol, and a high freedom from atrial fibrillation off antiarrhythmics which sustained to 3 years in patients with nonparoxysmal atrial fibrillation. The observed safety as well as the efficacy of the system and Cox Maze IV procedure lend support to the Class I guideline recommendation for concomitant atrial fibrillation ablation in patients receiving cardiac surgery.