Long-term outcomes of 198 patients who underwent the Cox-Maze III procedure for treatment of paroxysmal (n = 113) or persistent or long-standing persistent AF (n = 85) have been reported.1289 The mean follow-up was 5.4 6 2.9 years. Among the 112 patients who underwent surgery only for AF treatment, 96% were in sinus rhythm with or without AAD therapy and 80% were in sinus rhythm and free of AAD therapy at the last follow-up. Among the 86 patients who underwent AF surgery in conjunction with other cardiac surgery, 97% were in sinus rhythm with or without AAD therapy and 73% were in sinus rhythm free of AAD therapy. The incidence of major complications among the 112 patients who only underwent AF surgery was 11%. Among these were two perioperative deaths and two perioperative strokes or TIAs. Nine patients (8%) required pacemaker placement. The incidence of major complications among the 86 patients who underwent AF surgery at the time of other cardiac surgical procedures was 14%. Among these were one perioperative death and one perioperative stroke. Twenty patients (23%) required pacemaker placement.