At present, domestic and foreign experts have proposed many theories to explain the occurrence of atrial fibrillation, but no consensus has been reached on the mechanism of atrial fibrillation, so is there a single effective method to achieve a cure for atrial fibrillation? To answer this question, let’s start with a brief review of the main current treatment modalities for atrial fibrillation. Minimally invasive surgical techniques Surgical treatment of atrial fibrillation and reduction of thrombosis is performed by bilateral pulmonary vein isolation, left atrial and autonomic ganglion ablation, and left olecranon resection through small bilateral incisions or total thoracoscopy. Other atrial fibrillation treatment centers offer essentially similar procedures. The advantages of the minimally invasive surgical technique include high single cure rates, minimal trauma, continuous ablation lines with good wall penetration, the ability to treat the epicardial autonomic ganglia, and a simple and definitive approach to the left otocardium. However, there are some disadvantages: the inability to ablate the mitral and tricuspid isthmus, the inability to completely eliminate the risk of postoperative sinus tachycardia and atrial flutter, and the fact that patients are still apprehensive about undergoing surgical treatment due to the traditional psychological influence of patients and the lack of patient education. Internal catheter technique Internal isolation of pulmonary veins and ablation by percutaneous puncture in the endocardium. The success rate 6 years after a single catheter ablation has been reported internationally to be 29, with paroxysmal AF 36％ and persistent AF 15％. Then the advantages of internal catheter ablation include: less invasive, allowing endocardial markings and ablation of the mitral and tricuspid isthmus, making the patient’s heart more receptive. Disadvantages include: poor continuity and wall penetration of ablation lines, low single cure rate, high percentage of repeat treatments for patients, high cost, many complications, complex operation for physicians, long learning period, poor reproducibility of treatment operations, and large amount of radiation received by patients. Labyrinth surgery Labyrinth surgery is the gold standard in the treatment of atrial fibrillation, interrupting the pulmonary vein excitation point and the folding loop through “cut and sew”, and is the most effective way to treat atrial fibrillation. 91％ of patients can maintain sinus rhythm 10 years after surgery, but the trauma is greater. It is currently difficult to rely on purely minimally invasive surgical epicardial ablation or catheter endocardial ablation to complete the full maze of ablation line settings. So medical-surgical collaboration is needed! This is what we call – hybridization therapy. Atrial fibrillation hybrid therapy is defined as a patient receiving endocardial (medical catheter) + epicardial (minimally invasive surgical) atrial fibrillation ablation therapy. It can be simultaneous, it can be a medical-surgical treatment within a certain time frame, or even a recurrence of atrial fibrillation after one modality of treatment and then another atrial fibrillation treatment (e.g., medical catheter recurrence followed by surgical minimally invasive treatment), all of which are in line with the broad concept of hybridization. However, there is a problem here with the timing of hybridization. Simultaneous hybridization, or what we call simultaneous medical and surgical treatment in the operating room, has the disadvantages of high cost, long operative time, and high damage. Staged hybridization, i.e. treatment at intervals or after recurrence, avoids these problems to some extent and is the best option allowed by the current state of the medical system, and if a single treatment cures atrial fibrillation, the patient does not need to undergo a second treatment. So should the patient have medical or surgical treatment first? Internal medicine first, with intraoperative markers to guide subsequent surgical treatment, has a low single cure rate, with approximately 80 patients requiring a second medical catheter ablation or minimally invasive surgical procedure after the first catheter ablation. If surgery is done first, the single cure rate is high, with only about 40 patients requiring minimally invasive surgery followed by medical catheter ablation, but most patients currently have a heavy burden of thinking about “surgery”. I personally understand that the combination of medical and surgical procedures, i.e., “hybrid therapy”, is the ultimate direction of development in the treatment of atrial fibrillation, and that staged hybridization is the most desirable form of atrial fibrillation treatment under current medical conditions, and that the order of medical and surgical treatment needs to be chosen by the patient after thorough consideration.