Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and associated with significant morbidity and mortality.  AF is currently estimated to affect over seven million people worldwide and is predicted to increase in prevalence (1, 2).  Medical, surgical, and interventional approaches have been utilized to treat AF.  Systemic toxicity and limited therapeutic efficacy of antiarrhythmic medications has resulted in extensive development of surgical and interventional techniques for treatment of AF.  In addition to limiting the use of antiarrhythmic medications, these approaches have the added benefit of restoration of normal sinus rhythm (NSR).  Although restoration of NSR was not shown to be superior to a rate control management strategy in the AFFIRM trial, follow-up analysis indicated a 47% reduction in mortality associated with the presence of NSR (3).  Maintenance of NSR presumably provides an increase in cardiac output due to restoration of atrial systolic function and allows for the possible cessation of anticoagulation thus reducing risk of bleeding.