Abstract Background: Surgical ablation is inovated for patients with atrial fibrillation undergoing cardiac procedure. Aim of Study: Comparing postoperative rhythm outcomes and incidence of pacemaker implantation in complete biatrial ablation or pulmonary vein isolation (PVI) in consistent with other cardiac surgery. Patient and Methods: Between 2019 January and January 2022 a total of 59 patients with surgical procedure underwent either biatrial ablation or PVI in the National Heart Institute, Egypt. Assessement of the patients was done by 12 lead ECG and holter. All data on outcomes and patient characteristics were collected retrospectively. Results: 30 patients underwent complete biatrial procedure whereas 29 underwent PVI. In patients with persistent/long-standing atrial fibrillation, freedom from atrial fibrillation there was no big statistical difference between biatrial ablation and PVI, 24 patient (80%) and 23 (79.3%) respectively this is due to the selection of type of AF for each procedure and the incidence of CHB is more common in biatraial ablation procedure. The incidence of permanent pacemaker insertion was more common after biatrial ablation 4 (13.3%) and 1 (3.4%) respectively; p=0.353, no sex predilection but the incidence of postoprtative AF was more common in patient above 65 years old. Conclusions: Patients with persistent AF biatrial ablation is more effective than PVI in management of postoperative atrial fibrillation. Though the needing of a permanent pace-maker is higher after biatrial ablation, compared to PVI.