Atrial fibrillation (AF) is common among patients with mitral valve disease, and surgical ablation of AF is often performed in these patients when they are undergoing their valve surgery. A randomized trial involving 260 patients has assessed whether surgical ablation of AF during mitral valve surgery is actually associated with reduced recurrence of AF. The primary end point—freedom from AF at 12 months—was more likely among the trial participants who underwent surgical ablation (63.2% vs 29.4%, P <0.001). Notably, though, the rate of permanent pacemaker implantation was also significantly higher amongst these individuals (1-year incidence rate ratio 2.64; 95% CI 1.20–6.41; P = 0.01). The investigators point out that “establishing the effects of ablation on long-term survival, stroke incidence, the need for hospitalization, repeat rhythm procedures, and freedom from anticoagulation therapy requires further study.”