Convergent procedure for non-paroxysmal atrial fibrillation: a light in the darkness

The 2010 Global Burden of Disease Study has clearly evidenced the worldwide progressive increase in the burden, incidence, prevalence and associated mortality of atrial fibrillation (AF) during the last decades [1]. Of note, it also showed a clear underestimation and regional heterogeneity for the diagnosis of AF [1]. Because of the above-mentioned epidemiology, AF surgery has gained progressive attention and widespread application in the surgical community, with the Cox-maze IV being still the gold standard procedure to surgically treat AF [2]. However, the invasiveness of the Cox-maze IV has limited its application in isolated AF, i.e. in the absence of an associated surgical heart disease [3].