The Dallas Lesion Set was developed to create a complete approach, which can be performed on a beating heart without cardiopulmonary bypass.1339,1340,1341 The set replicates the LA lesions of the Cox-Maze III, but changes the connection of the PVI to the aortic annulus in continuity with the mitral. Early results have been published on 30 patients.1339,1340 The group included 10 patients with persistent AF and 20 patients with long-standing persistent AF. Electrocardiographic long-term monitoring and the use of AAD data were collected 6 months postprocedure, and follow-up was 100%. Procedure-related complications did not occur during follow-up, nor were there any deaths. At 6 months of follow-up, 90% of the patients with persistent AF and 75% of the patients with long-standing persistent AF were in sinus rhythm. AAD therapy was continued in 22% of the patients with persistent AF and 53% of the patients with long-standing persistent AF. In a series of 100 paroxysmal patients randomized to include the Dallas Lesion Set or not, the additional lesion, as expected in a paroxysmal population, did not impact success at 16 months of follow-up.520 Much like the results of catheter ablation, this suggests that the type of AF will influence the success of the procedure. Persistent AF is likely to require a more extensive lesion set. An important area of interest is the decision to offer a patient surgery or catheter ablation.