2015 SURGICAL ABLATION OF ATRIAL FIBRILLATION TRIAL Surgical ablation of atrial fibrillation during mitral-valve surgery parallel, randomized controlled trial M Objective: To evaluate treatment with mitral valve surgery plus ablation compared with mitral valve surgery alone among patients with mitral valve disease & persistent AF undergoing open heart surgery. 260 patients Inclusion criteria: Patients with mitral valve disease undergoing open heart surgery and persistent (>7 days) or long-standing persistent (>1 year) atrial fibrillation (AF) Mitral valve surgery plus ablation (n=133) 63.2 VS Mitral valve surgery alone (n=127) PRIMARY OUTCOME Freedom from atrial fibrillation at 12 months % 29.4 P <0.001 SECONDARY OUTCOMES 6.8 One-year mortality% 8.7 HR 0.76; 95% CI, 0.32 to 1.84; P=0.55 21.5 Implantations of permanent pacemaker (per 100 patient-years) 8.1 P=0.01 Conclusion: The addition of AF ablation to mitral-valve surgery significantly increased the rate of freedom from AF at 1 year among patients with persistent or long-standing persistent atrial fibrillation, but the risk of implantation of a permanent pacemaker was also increased AM Gillinov et al. NEJM 2015; 372:1399-1409