Conversion to Sinus Rhythm by Ablation Improves Quality of Life in Patients Submitted to Mitral Valve Surgery

Successful radiofrequency ablation determines atrio-ventricular remodelling and improves systo-diastolic function at tissue Doppler-imaging☆

“…It can be therefore expected that the restoration of an adequate rhythm or at least of the rate, will positively influence the ventricular function. Accordingly, we have found a significant recovery of the functional status in all patients undergoing surgery, confirming previous reports by Stulak and co-workers [16] and Gillinov and co-workers [6]; furthermore Forlani and co-workers [19] evidenced in a retrospective study that the recovery of the SR in patients undergoing mitral valve surgery improved the quality of life assessed by the Short Form 36 (SF-36) Health Survey, despite the Authors did not found any difference in ejection fraction, left atrial diameter, mitral dysfunction, tricuspidal regurgitation, and New York Heart Association functional class; on the other side, Jessurun and colleagues [20] reported in a prospective randomized study that patients with AF and mitral pathology had a quality of life that was markedly improved after valve surgery, but was not different between patients with or without maze surgery. Our study showed that despite all patients recovered their functional status because of the relief of the valve pathology, only those who parallel recovered the heart rhythm demonstrated a further improvement in their symptoms; moreover, patients with AF-persistence demonstrated only an initial amelioration of their NYHA, whereas SR-patients further improved during the folllow-up time-course, together with a better freedom from hospital admission and episodes of acute decompensation; all these data seems to indicate a first recovery of the haemodynamic due to the correction of the valve disease, further progressive during follow-up only in those who recovered also the cardiac rhythm.…”

Pulmonary vein isolation combined with substrate modification for persistent atrial fibrillation treatment in patients with valvular heart diseases

“…Multiple studies12 13 14 15 16 17 18 have demonstrated that valve surgery concomitant with Maze or surgical ablation can eliminate AF in up to 75–99% patients. The operative mortality is about 2%.…”

Comparison of amiodarone and propafenone for maintenance of stable sinus rhythm after bipolar radiofrequency ablation combined with a mitral valve procedure in patients with mitral valve disease and persistent atrial fibrillation

“…[10,11] Restoration of sinus rhythm by ablation leads to a greater quality of life (QoL), especially when compared with patients who have persistent AF that experience a sustained abnormal heartbeat and undergo mitral valve surgery. [12] Moreover, Pappone et al [13] reported reduced mortality and morbidity and an improved QoL in patients who underwent circumferential pulmonary vein ablation for AF versus those treated with medical therapy alone. In our study, no hospital mortality occurred.…”