The main complication in patients with atrial fibrillation (AF) is stroke. Atrial fibrillation combined with stroke: therapeutic decision making is key, and high-risk patients can be treated with drugs, electrical cardioversion or catheter ablation to revert sinus rhythm, as well as long-term effective anticoagulation with warfarin and new anticoagulants. Minimally invasive surgery is another safe option for high-risk patients Surgical Maze Type III is the gold standard for the treatment of atrial fibrillation, with a long-term cure rate of 90%, but because of its difficulty and trauma, it is mainly used as an add-on treatment for atrial fibrillation during valve surgery. In recent years, indications for minimally invasive surgery have included patients with atrial fibrillation with left atrial thrombosis, a history of thromboembolism, and contraindications to antithrombotic drug therapy. The 2014 ACC/AHA/ESC Guidelines for the Treatment of Atrial Fibrillation state that minimally invasive surgery, including thoracoscopy, may become a treatment option for more patients with AF, with the main steps being bilateral pulmonary vein isolation, linear ablation of the left atrial circumflex pulmonary vein, partial denervation of the epicardium, and left olecranon resection. The advantages are minimal injury, rapid and accurate operation, few complications, and good outcomes. Internationally, paroxysmal atrial fibrillation is the main treatment target, including some permanent atrial fibrillation, with an overall cure rate of 91.3% at 6 months. but also AF patients with left atrial thrombosis, a history of previous thromboembolism (stroke or TIA), and contraindications to antithrombotic drug therapy. Patients with atrial fibrillation who have had an acute stroke or transient ischemic attack (TIA) and poorly controlled blood pressure require antihypertensive therapy. If the imaging suggests no cerebral hemorrhage, anticoagulation should be given 2 weeks after the onset of the disease; if there is cerebral hemorrhage, anticoagulation should not be given. Patients with atrial fibrillation who have an acute TIA without significant hypertension and whose imaging suggests no cerebral infarction or cerebral hemorrhage should be treated with anticoagulation as soon as possible. In patients with atrial fibrillation with stroke, catheter ablation can further reduce the risk of recurrent stroke; those with a CHA2DS2VASc score ≥2 and a high-risk risk stratification for stroke should be treated with long-term warfarin anticoagulation with an INR of 2.0 to 3.0, regardless of whether sinus rhythm is maintained, if the patient maintains an effective INR of 2.0 to 3.0. In some patients who cannot be anticoagulated with warfarin for a long period of time, left-ear occlusion may be considered to effectively reduce the risk of stroke, but there are more perioperative complications.