The Korean Heart Rhythm Society recently added the hybrid atrial fibrillation ablation using thoracoscopy to the atrial fibrillation treatment guideline.The hybrid atrial fibrillation ablation is a state-of-the-art therapy that combines surgery and internal medicine treatment. Its targets patients with recurrent atrial fibrillation, who did not respond to or were not successful in the conventional internal medicine treatment.The treatment involves drilling a 0.5cm hole in the chest and directly looking at the heart through a thoracoscopy to block the arrhythmogenic region with bipolar high frequency. if abnormal electrical signals are still detected about three months after the surgery, the internal medicine treatment is used. Compared to the conventional therapy, which involved opening the chest and stopping the heart during the surgery, the hybrid atrial fibrillation ablation only takes 90 minutes on average for the surgery, putting less pressure on patients, and only requires 4-day hospitalization, despite its high difficulty. In particular, this procedure is highly advantageous in that it can remove left atrium, a major cause of stroke, which commonly appears in patients with atrial fibrillation.The arrhythmia team at the SMC Heart, Vascular and Stroke Institute has carried out more than 430 cases and has the most procedural experience in Korea. This indicates that the rate of symptom disappearance or normal heart rate maintenance after two years of receiving the hybrid atrial fibrillation ablation has reached 95%.Professor Dong Seop Jeong at SMC Department of Cardiology said, “The hybrid atrial fibrillation ablation, including the surgical resection using thoracoscopy, has become one of the critical treatment options for patients with atrial fibrillation.”