On Aug. 27, a patient with recurrent atrial fibrillation after repeated catheter ablation was successfully treated by a medical-surgical one-stop hybrid procedure, which is the highest level in the field of atrial fibrillation treatment, signifying that our cardiac center has reached the world’s most advanced level in the diagnosis and treatment of complex arrhythmias. Ms. Yu, 59, from Chongqing, has been suffering from recurrent “chest tightness and panic” for 15 years, and in severe cases, she even has “dizziness and blackness”. Atrial fibrillation. The doctor told her that atrial fibrillation is a common cardiac arrhythmia, and that repeated attacks on the atria can lead to the loss of effective contraction, resulting in the formation of thrombus in the atria, which can easily cause serious consequences such as brain embolism and arterial embolism in the limbs after dislodgement. Ms. Yu had undergone two radiofrequency ablation procedures for atrial fibrillation 3 years ago and 1 year ago respectively, but after the operations, atrial fibrillation still recurred and the treatment effect was not satisfactory. This time, she came to our cardiac center, hoping to cure the “heart disease” that had been bothering her for 15 years. After consulting with Wei Meng, Li Jingbo and Zhang Qingyong, directors of the Cardiology Department, they analyzed that the patient’s recurrence after radiofrequency ablation twice in an outside hospital was considered to be related to ectopic pacing foci in the pulmonary veins, and that it would be difficult to achieve the desired effect with simple drug control or internal radiofrequency ablation. At this time, an idea gradually emerged in the hearts of the two directors: why not use our newly completed complex operating room with advanced equipment and our powerful cardiac center platform this year to use combined medical and surgical procedures to strive for the eradication of atrial fibrillation! After receiving the invitation, Director Reed Feng of the Cardiovascular Surgery Department carefully evaluated the patient’s condition, and his idea coincided with that of his medical colleagues. After discussion, it was determined that epicardial ablation combined with endocardial ablation is currently the best option for the treatment of atrial fibrillation, and the cure rate can reach 90-95%. The patient’s right and left pulmonary veins were ablated and isolated by a cardiac surgeon through thoracoscopy. Since left auricular thrombosis is the culprit of stroke in 90% of patients, the left auricle can be ligated during the surgical procedure to eliminate the risk of stroke due to atrial fibrillation at its root. In contrast, the cardiologist verifies that the pulmonary veins are isolated by labeling the intracardiac electrograms and performs endocardial patch ablation for areas that are still imperfect, as well as ablative blocking of the tricuspid isthmus line that cannot be ablated by surgical thoracoscopy. The advantages of surgery and cardiology in the hybrid surgery center complement each other, thus allowing the patient to obtain the maximum benefit. Everything was ready, and Ms. Yu was admitted to our hybridization operating room. After successful anesthesia, Director Reed firstly freed the left and right upper and lower pulmonary veins respectively with the assistance of thoracoscopy, isolated the abnormal potential of pulmonary veins with bipolar RF ablation forceps, and ligated the patient’s left heart ear. Then, under the guidance of Zhang Qingyong, director of the Department of Cardiology, the residual potentials of the pulmonary veins were detected and ablated with the help of a three-dimensional calibration system, and linear ablation of the left atrial low voltage area, tricuspid annulus and electrical isolation of the superior vena cava were performed to eliminate the “foci” of atrial fibrillation as much as possible. The operation went very well, with a history of less than 4 hours. The patient was awake and extubated 30 minutes after the operation, and resumed eating and getting out of bed the next day. Several postoperative electrocardiogram reviews confirmed normal sinus rhythm. The successful performance of this operation affirmed our hospital’s leading position in the field of atrial fibrillation treatment in China, and laid the foundation for further promotion of medical-surgical one-stop hybrid ablation surgery for atrial fibrillation, thus better serving the majority of atrial fibrillation patients. Postscript: Although medical catheter ablation of atrial fibrillation has been performed for more than 10 years, the success rate of single catheter ablation is still only about 55-80%. Surgical minimally invasive ablation (and) left auricular ligation using thoracoscopy still achieve limited success rates in most patients with AF. At present, for complex chronic AF (AF lasting for more than 2-3 years), especially for AF that has recurred after more than 2 catheter ablations, a combined medical and surgical minimally invasive one-stop hybrid procedure is expected to further increase the success rate of AF ablation significantly and is expected to achieve a complete cure. Currently, the industry believes that medical-surgical atrial fibrillation one-stop hybridization treatment has the following advantages: 1. more definite and lasting damage formed by ablation; 2. intraoperative left olecranon resection or ligation can be performed, thus fundamentally eliminating the risk of thrombosis and embolism due to atrial fibrillation; 3. facilitates ablation of the epicardial vagal ganglion; 4. maximizes the elimination of the substrate (soil) maintained by atrial fibrillation. Because of these advantages, endosurgical one-stop hybridization has become one of the most successful ablation procedures for the treatment of atrial fibrillation.