It was evaluated the influence of the main risk factors of atrial fibrillation recurrence after Cox-Maze 4 surgery. Cox-Maze 4 surgery was done simultaneously with the correction of acquired heart disease or coronary bypass under extracorporeal circulation. The study included 141 patients, including 82 (58%) women and 59 (42%) men aged between 30 and 70 years (middle age was 58,8±11,0 years). 128 (91%) of patients had persistent AF, 13 (9%) - paroxysmal. The patients were divided into 2 groups. The group 1 included 84 persons with the presence of two risk factors. Group 2 included 57 patients with a combination of the three main risk factors of atrial fibrillation recurrence. In the case of the open surgery on the heart all patients had Cox-Maze 4 surgery with equipment for monopolar and bipolar ablation. Long-term results (from 6 months to 3 years) were studied in 100 % of patients. The average NYHA functional class was 1,9±0,6. In group 1 sinus rhythm was maintained in 78 (93%) patients during long-term. AF was diagnosed in 6 (7%) patients. In group 2 sinus rhythm remained in 45 (78%) patients, in 12 (22%) patients was observed AF. Actuarial index of lack of atrial fibrillation recurrence was 88±0,3% in the first group, in the second group - 62±1,6% (p=0.04). It was concluded that a combination of three risk factors significantly increases the risk of atrial fibrillation recurrence. The most significant risk factors for AF recurrence are the patient's age and size of the left atrium.