Over the past decade, there have been significant changes in the field of methods and technologies in the treatment of atrial fibrillation (AF). Improving the technique of performing surgical manual has significantly improved the results of surgical and interventional treatment of arrhythmia, taking into account the pathophysiological features of its occurrence, based on the mechanisms of macro-reentry and ectopic trigger activity. Despite the fact that catheter ablation of the pulmonary veins in the paroxysmal form of AF shows its effectiveness, the optimal tactics of surgical treatment in the persistent form of AF is still not determined. Isolation of the pulmonary veins in the persistent form of AF often leads to recurrence of arrhythmia, and even after several procedures, the probability of success may be low. The risk of recurrence of AF may be secondary to triggers outside the pulmonary veins, and additional treatments are currently being studied for better control of the persistent form of AF. The left atrium appendage is a complex structure with certain electrophysiological properties. Numerous studies have shown that the left atrium appendage is a potential substrate for the occurrence of AF. The therapy aimed at electrical isolation of the left atrium appendage has demonstrated potential effectiveness in ensuring freedom from AF. The general concept of this therapy is to perform electrical isolation of the atrium from the appendage by catheter ablation, surgical excision or ligation, and percutaneous ligation of the left atrium appendage. Electrical isolation of the left atrium appendage has already demonstrated advantages in reducing the frequency of AF recurrences. And also, the electrical isolation of the left atrium appendage may become the basis for optimal control over the rhythm in AF, which undoubtedly deserves further study and is the subject of discussion in this article.