These reports suggest that there are many factors for surgical failures after AF treatment. It is likely that catheter ablation can help selected patients restore sinus rhythm after failures. These treatments should be performed at experienced centers by experienced individuals who will tailor the procedure to the individual patient based on initial lesion set, the ablation technology and strategy used during initial AF surgery, and the results of extensive mapping and provocative testing at the time of the redo ablation procedure. As the experience with new hybrid approaches evolve, more definitive conclusions should arise.