More data concerning thoracoscopic epicardial ablation and combined epicardial-endocardial ablation procedures have been published since the last AF ablation consensus statement. In addition to a potentially more durable lesion set, other advantages of an epicardial approach include access to epicardial structures such as the ligament of Marshall and GP, management of the LAA, and avoidance of damaging collateral structures, such as the PN and esophagus.