In reviewing the history of treatment of atrial fibrillation (AF), although early studies concluded that AF was common in patients with mitral valve disease and other heart conditions, it is only in recent years that AF treatment has become routine in cardiac surgery. This important development can be attributed to a better understanding of the pathophysiological mechanisms and risks of atrial fibrillation, as well as the development of new surgical ablation energy sources. For current surgical treatment, the aim of the procedure is to address both atrial fibrillation and organic cardiac pathology; it is estimated that in 2007, more than 10,000 surgical ablation procedures were performed worldwide. Also in 2007, minimally invasive cardiac surgical ablation procedures were rapidly developing in many countries and regions of the world, providing an exciting treatment option for patients with isolated and paroxysmal atrial fibrillation. For surgical treatment of atrial fibrillation, the fundamental reason for the high cure rate lies in the advanced, scientific and practical nature of the treatment concept, and also in the corresponding technical features guided by the treatment concept. First of all, the key concept of surgical ablation, which is also the most important feature of the surgical technique, is the wall penetration and continuity of the ablation line. Only a permeable ablation line can completely block the presence and conduction of the folding loop, and only a complete ablation in isolation can completely block the ectopic foci in the vestibular region of the pulmonary veins. The incision is healed to create a transmural scar, thus achieving a cure for atrial fibrillation. In Cox’s experience, 306 labyrinth surgeries were performed from 1989 to 1999, with the exception of patients with mechanical valve replacements, all of whom were taken off anticoagulation therapy after surgery, and only one patient had a stroke (0.3%) in the long term, which was directly related to the recovery of left atrial systolic function and the removal of the left auricle. On the other hand, for any treatment of atrial fibrillation, there is the reality of recurrent atrial fibrillation for a certain period of time after treatment or failure of long-term treatment, in which case the patient is still at risk of thrombosis, but the removal of the left auricle means the elimination of the site of high thrombosis, which can still reduce the chance of thromboembolism to a certain extent in the absence of recovery of left atrial function, especially in the case of Patients who are elderly, have difficulties with anticoagulant monitoring, or in whom anticoagulation is contraindicated may still have a significant benefit. Although the mechanism of vagal influence on the development of atrial fibrillation has long been recognized, the real elimination of the vagus nerve as a treatment is a new direction of research. pappone performed circumferential pulmonary vein isolation ablation (CPVA) in 297 patients, while targeting all the At 12 months of follow-up, 85% of patients without vagal response were in sinus rhythm, while 99% of patients with vagal response who underwent complete denervation returned to sinus rhythm. However, for catheter ablation, because the vagal ganglion is located in the epicardium, targeted targeting and transmural ablation is significantly more difficult than for surgical procedures. The Marshall ligament, located between the left pulmonary artery and the left upper pulmonary vein, is also a high distribution area for vagal ganglia and is the site of origin of some focal AF, making it an important target for AF treatment. However, it cannot be treated with conventional catheter techniques. In contrast, in direct cardiac ablation, the distribution of vagal ganglia is easily identified using high frequency stimulation (HFS), and targeted epicardial ablation can be performed while severing Marshall’s ligament in a few minutes, making epicardial denervation a new target and advantage of current surgical ablation procedures for AF.