We recommend that a surgical AF ablation procedure be undertaken in association with mitral valve surgery in patients with AF when there is a strong desire to maintain sinus rhythm, the likelihood of success of the procedure is deemed to be high, and the additional risk is low. (Recommendation Strong, Quality Moderate)<br /><br /><b>Values and preferences: </b>This recommendation recognizes that individual institutional experience and patient considerations best determine for whom the surgical procedure is performed.