For Some AFib Patients, Minimally Invasive Surgery Should Be Discussed

A Keck Medicine of USC cardiothoracic surgeon explains why epicardial ablation may be the right treatment for some patients with longstanding persistent AFib.

By
February 10, 2026
7 min

Keck Medicine of USC

Overview

Minimally invasive epicardial ablation may be a viable treatment option for patients with longstanding persistent atrial fibrillation (AFib) who do not respond well to medication or endocardial ablation. Early discussions about surgical options are essential to improve patient outcomes, as they can lead to timely interventions and better management of symptoms.

Background

Atrial fibrillation (AFib) is a common arrhythmia that can present in various forms, with longstanding persistent AFib accounting for 10%-20% of cases. Traditional treatments often focus on medication and endocardial ablation, which may not be effective for all patients, particularly those with longstanding persistent AFib. Understanding alternative surgical options, such as epicardial ablation, is crucial for optimizing treatment strategies for this patient population.

Data Highlights

No numerical data available in the source material; consider including qualitative findings or expert opinions.

Key Findings

Longstanding persistent AFib patients may not achieve successful outcomes with medication or endocardial ablation alone.
Epicardial ablation is a minimally invasive surgical option that can be considered for patients who do not respond to other treatments.
Discussions about surgical options are often delayed, leading to prolonged symptoms and potential complications.
Studies indicate that the longer a patient remains in AFib, the lower the likelihood of successful treatment outcomes.
Patients should be referred to a cardiac surgeon early in the treatment process to explore all available options.

Clinical Implications

Healthcare providers should ensure that patients with longstanding persistent AFib are informed about all treatment options, including surgical interventions. Early referral to a cardiac surgeon can facilitate timely discussions about epicardial ablation, potentially improving patient outcomes.

Conclusion

Incorporating discussions of minimally invasive surgical options early in the treatment process for longstanding persistent AFib patients is essential for optimizing care and improving long-term outcomes.