Figure 5.

Graphical abstract highlighting the results of this implementation science based survey of cardiothoracic surgeons in the VCSQI (54.3% response rate) and the MSTCV (44.9% response rate). A majority of respondents performed a moderate volume of mitral valve surgery (10–50 cases/year) with lower volume surgeons significantly more likely to report barriers to concomitant AF ablation related to patient risk or resource availability. There were 12.1% of surgeons unaware of societal guidelines while about half of respondents had formal training in AF ablation. While 46% of respondents reported no barriers, the most common barriers reported were related to patient risk and procedure safety. Finally, proposed interventions included increased support from cardiology/EP, stronger evidence, and mentorship/education including site visits and videos.