Atrial fibrillation (AF) has become a serious health threat in China, and as the most common arrhythmia, it is likely to become one of the biggest public health problems in the next 10 years. According to the findings of the National Heart Lung and Blood Institute (USA) in 2005, the number of patients with atrial fibrillation in China is currently about 9 million, the highest absolute number in the world. It should be further noted that, according to the first large-scale epidemiological study of AF in China, paroxysmal and isolated AF accounts for more than 1/3 of the total number of patients. In other words, there are more than 3 million patients with paroxysmal and isolated atrial fibrillation in China, which is undoubtedly one of the groups of atrial fibrillation patients that need key interventions. Han Jie, Cardiac Surgery Center, Beijing Anzhen Hospital From the perspective of treatment principles and patients for whom they are suitable, atrial fibrillation can be generally classified into two major categories: the first category is paroxysmal and isolated atrial fibrillation, i.e., patients with atrial fibrillation without serious organic heart disease; the second category is atrial fibrillation that is complicated by organic heart disease. Based on the above classification, the current treatment methods for atrial fibrillation can be divided into two major categories, one is catheter interventional ablation technique, which is mainly suitable for the first category, i.e. paroxysmal and isolated atrial fibrillation. The second is cardiac surgical ablation techniques, which are mainly suitable for the second group of patients with atrial fibrillation that require surgery to resolve cardiac disorders, such as valve disease, coronary artery disease, and precordial disease. For a long time, these two AF treatment techniques have been developed in parallel due to the difference in the population for which they are indicated. The catheter-based interventional ablation technique has been developing rapidly, and the number of patients benefiting from it has been increasing worldwide with the continuous improvement of calibration systems and techniques and the development of new theories. In the field of cardiac surgery, with the development of minimally invasive cardiac surgery techniques, the scope of surgical treatment of atrial fibrillation is now expanding beyond the original indications to the main targets of catheter intervention, namely isolated and paroxysmal atrial fibrillation. Minimally invasive ablation techniques have been reported worldwide: thoracoscopic Dry Radiofrequency (Wolf Mini-maze) ablation, thoracoscopic combined with robot-assisted Irrigated Radiofrequency (IRF) ablation, thoracoscopic Microwave The overall characteristics of these techniques are small incision, application of advanced ablation energy device, combined with thoracoscopic technology, ablation of epicardium in the state of non-stop beating of the heart, the advantages are less damage to the patient, precise and rapid operation, less complications and high efficacy. high efficacy. For example, Pruitt et al. published in the Annals of Thoracic Surgery in August 2006 their experience of performing minimally invasive microwave ablation in 50 patients with atrial fibrillation (33 with paroxysmal and 17 with persistent atrial fibrillation) who had failed drug therapy. Among them, bilateral epicardial pulmonary vein isolation was performed in paroxysmal AF, bilateral linear ablation was performed in persistent AF, and left auricular resection was performed in 46 patients at the same time. However, given the complexity of atrial fibrillation treatment and the high re-ablation rate of catheter ablation, there are four criteria to be considered when evaluating whether a procedure meets the requirements of minimally invasive ablation techniques and whether it truly achieves the goals of curing atrial fibrillation and eliminating the risk of thrombosis and embolism The first step is to understand whether the ablation energy applied for the procedure can actually guarantee the required wall penetration during the epicardial operation. For example, microwave ablation and HIFU ablation, although the two energy sources are ideal, due to the limitations of their ablation devices, they cannot guarantee a good contact between the ablation electrodes and the atrial wall, and may leave a gap between them. Akpinar recently reported the use of da Vinci robotic system combined with a flushing monopolar radiofrequency ablation system for mitral valve surgery and simultaneous radiofrequency ablation for the treatment of atrial fibrillation, although it used the most advanced surgical system to perform all operations with a small incision, it still cannot be called minimally invasive surgery. The procedure can be called minimally invasive surgery. 3. Whether the procedure is performed on the left heart ear. A major advantage of the surgical procedure over catheter ablation is the possibility of performing left auricular resection in patients with left auricular thrombosis, thus eliminating the risk of embolism, even if the patient with atrial fibrillation is not yet thrombosed, and the risk of left auricular resection can be significantly reduced. If this requirement cannot be met or is difficult, as in the case of HIFU ablation, then it is not considered an ideal minimally invasive procedure. 4. For example, the role of autonomic nerves in the mechanism of atrial fibrillation has been increasingly emphasized, and the distribution of GPs is under the epicardium, so it is undoubtedly a reflection of the advanced surgical technology, including minimally invasive surgery, to mark them during surgical procedures and to perform ablation therapy under the guidance of the results. In summary, the representative technique for minimally invasive ablation treatment of atrial fibrillation should be the thoracoscopically assisted Wolf Mini-maze procedure in terms of treatment concept, technical difficulty, clinical development time, number of treatment cases, medium- and long-term efficacy, and feasibility of application. The Wolf Mini-maze procedure was proposed by Dr. Randall Wolf of the University of Cincinnati College of Medicine in 2002 and has been implemented in clinical practice and gradually perfected as a minimally invasive cardiac surgical procedure. Specifically, the procedure is performed by making three small incisions between the ribs on each side of the patient and using a bipolar radiofrequency device (Atricure TM) under thoracoscopic surveillance. The main operations include four: extensive isolation of bilateral pulmonary veins; linear ablation of the left atrium; partial denervation of the epicardium; and excision of the left auricle.