Surgical treatment of lone atrial fibrillation

currently, off-pump video-assisted thoracoscopic epicardial pulmonary vein isolation offers an attractive alternative to on-pump maze procedures for surgical treatment of lone atrial fibrillation. nevertheless, on-pump maze procedures through a mid-sternotomy approach still play an important role in patients with lone atrial fibrillation on many occasions, especially in patients with failed percutaneous pulmonary vein alone. the aim of this article was to give a brief review of the surgical strategies for treating lone atrial fibrillation, and present the possible indications for on-pump maze procedures through a mid-sternotomy approach.