The Cox-Maze III procedure (CMP) has excellent long-term efficacy in curing atrial fibrillation (AF). However, it has not been widely adopted because it is technically challenging and requires prolonged cardiopulmonary bypass times. This video presents a simplified CMP utilizing bipolar radiofrequency (RF) energy as an ablative source to replace most of the traditional cut and sew lesions. The only surgical incisions remaining are one right and one left atriotomy, as well as a small incision in the right atrial appendage and excision of the left atrial appendage. This patient is a 35 year old male that had a three (3) year history of paroxysmal atrial fibrillation (PAF). He presented in congestive heart failure with an ejection fraction of 10%. The patient underwent unsuccessful drug trials of both amiodarone and sotalol. He subsequently underwent a four (4) vessel pulmonary vein ablation in the electrophysiology laboratory in June, 2003. After this intervention, the PAF persisted and he was referred to our institution for surgery. At the time of presentation, an echocardiogram revealed his ejection fraction to be 25% with a left atrial diameter of 4.1 cm. His cardiac catheterization showed normal coronary arteries and a dilated cardiomyopathy with an ejection fraction of 20%. He was scheduled for a lone maze procedure which is presented in the accompanying video. Since January 2002, 46 consecutive patients have received the modified Cox-Maze Procedure. The mean cross-clamp time was reduced significantly (p<0.001) compared to the traditional cut-and-sew CMP. Follow up magnetic resonance imaging in the first eight patients demonstrated no evidence of pulmonary vein stenosis and preservation of atrial contractility in each patient. There have been no late strokes and at six month follow up 91% of patients (30/33) were in sinus rhythm. In conclusion, bipolar RF ablation can be used to replace the surgical incisions of the Cox-Maze procedure. This energy source did not result in pulmonary vein stenosis. The modified CMP, using bipolar RF ablation, simplified and shortened the procedure, without sacrificing short-term efficacy.