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作者

刘庆利 贾照林 李红昕

作者单位

山东第一医科大学(山东省医学科学院)研究生部，山东 济南 山东第一医科大学第一附属医院结构性心脏病外科，山东 济南

刊名

Advances in Clinical Medicine

年份

2026

卷号

Vol.16 No.6

页码

2002-2013

ISSN

2161-8712

关键词

心房颤动 外科消融 Cox-Maze手术 射频消融 术后复发 复发机制 预测因素 管理策略 Atrial Fibrillation Surgical Ablation Cox-Maze Procedure Radiofrequency Ablation Postoperative Recurrence Recurrence Mechanisms Predictive Factors Management Strategies

摘要

Atrial fibrillation is the most common sustained cardiac arrhythmia, with its incidence rising markedly with advancing age and closely linked to increased risks of stroke, heart failure, and all-cause mortality. Surgical radiofrequency ablation, represented by the Cox-Maze series of procedures, constitutes an important therapeutic approach for AF, particularly in patients with concomitant indications for cardiac surgery. From the classic “cut-and-sew” Maze procedure to modified techniques based...更多

Atrial fibrillation is the most common sustained cardiac arrhythmia, with its incidence rising markedly with advancing age and closely linked to increased risks of stroke, heart failure, and all-cause mortality. Surgical radiofrequency ablation, represented by the Cox-Maze series of procedures, constitutes an important therapeutic approach for AF, particularly in patients with concomitant indications for cardiac surgery. From the classic “cut-and-sew” Maze procedure to modified techniques based on radiofrequency energy, this technology has continuously evolved, enhancing safety and procedural ease while maintaining a high rate of sinus rhythm restoration. However, postoperative AF recurrence remains a central challenge affecting long-term efficacy, with reported incidence varying across studies and underlying mechanisms that are complex and multifactorial. This review aims to systematically delineate the developmental trajectory of surgical radiofrequency ablation, appraise its clinical efficacy and safety, and thoroughly explore the epidemiological features, potential predictors, pathophysiological mechanisms, and current and emerging prevention and management strategies for postoperative recurrence, thereby providing an evidence-based foundation for optimizing surgical decision-making in AF and improving long-term patient outcomes.收起

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