Patients with minimal atrial fibrillation events should not undergo concomitant atrial ablation during open heart procedures.

Several randomized controlled trials and meta-analyses have demonstrated improved freedom from atrial fibrillation with intraoperative atrial ablation. However, the increased bypass time and the risk for ablation-related complications should be weighed against the benefits in the decision-making. It is important to establish reasonable criteria to define candidates for surgical ablation. Furthermore, the efficacy and short- and long-term risks related to surgical ablation need to be considered. This article reviews the data on surgical ablation of atrial fibrillation as it pertains to these important issues. As shown the evidence does not support surgical ablation at the time of coronary artery bypass graft in some patients.