Efficacy of Surgical Ablation of Atrial Fibrillation in Patients With Rheumatic Heart Disease

Sternik, Leonid; Luria, David; Glikson, Michael; Malachy, Ateret; First, Maya; Raanani, Ehud

doi:10.1016/j.athoracsur.2010.01.047

Cited by 9 publications

(13 citation statements)

References 19 publications

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“…Although patients with RHD had significantly lower success rate at discharge in comparison with patients with degenerative disease, this difference dissipated at three months and long‐term follow‐up. This is in keeping with previous findings that the etiology (rheumatic or degenerative) seems to have no impact in terms of SR maintenance . One possible explanation is the fact that patients with RHD have more severe remodeling and require more time for the arrhythmia to be abolished.…”

Section: Discussionsupporting

confidence: 91%

“…Therefore, this is in line with most of the prior reports . However, controversy is ongoing with some reports showing no influence of LA size on long‐term outcomes . Tricuspid valve disease appeared as a risk factor for AF recurrence in the univariate analysis.…”

Section: Discussionsupporting

confidence: 87%

“…25 However, controversy is ongoing with some reports showing no influence of LA size on long-term outcomes. 11 Tricuspid valve disease appeared as a risk factor for AF recurrence in the univariate analysis. This might have been driven by the fact that patients with tricuspid valve disease tended to have more severe and longer valve disease, with associated atrial remodeling and thus more sustained arrhythmic substrate.…”

Section: Resultsmentioning

confidence: 90%

“…This is in keeping with previous findings that the etiology (rheumatic or degenerative) seems to have no impact in terms of SR maintenance. 11 One possible explanation is the fact that patients with RHD have more severe remodeling and require more time for the arrhythmia to be abolished. However, within the three-month blanking period following ablation, heart rhythm variability is expected and assessment of ablation outcomes is not recommended by the guidelines.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Concomitant Unipolar Radiofrequency Ablation of Nonparoxysmal Atrial Fibrillation in Rheumatic and Degenerative Valve Disease

et al. 2014

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 87%

Section: Resultsmentioning

confidence: 90%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Concomitant Unipolar Radiofrequency Ablation of Nonparoxysmal Atrial Fibrillation in Rheumatic and Degenerative Valve Disease

et al. 2014

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“…There are little data available on RFA of atypical flutters with rheumatic MS. There are many studies focusing various aspects of AF, RFA of AF as well as surgical maze procedure in RHD. There are some data on the electrical substrate in rheumatic MS that predispose to AF .…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency Ablation of Left Atrial Reentrant Tachycardias in Rheumatic Mitral Valve Disease: A Case Series

Prabhu

Thajudeen

et al. 2016

Pacing Clinical Electrophis

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Factors related to sinus rhythm at discharge after radiofrequency ablation of permanent atrial fibrillation in patients undergoing mitral valve surgery

Rostagno

Gelsomino²,

Capecchi

et al. 2015

Heart Vessels

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Late recovery of sinus rhythm is unusual in patients with permanent AF treated by (radiofrequency) RF maze procedure during mitral valve surgery. Identification of clinical and instrumental preoperative factors predictive of early success of RF ablation in patients with permanent AF undergoing mitral valve surgery may improve selection of subjects to obtain long-term results. Hundred and thirty consecutive patients with permanent AF and mitral valve disease underwent modified RF maze procedure during concomitant mitral valve surgery. Rheumatic valve disease (61 pts) and mitral valve prolapse (41 pts) were the more common aetiology of valve abnormalities. Mitral valve replacement was performed in 54 % of patients and mitral valve repair in the remaining 46 %. Four patients died after surgery. At discharge, 87 patients (69 %) were in sinus rhythm (group 1) and 43 patients in AF persisted (group 2). At an average 24-month follow-up, sinus rhythm was present in 67 % of patients, and 33 % were in atrial fibrillation. In this period, late recovery of sinus rhythm was observed only in five patients, while eight discharged in sinus rhythm developed again atrial fibrillation. Among preoperative parameters at univariate analysis female sex, atrial fibrillation >24 months, left atrial diameter >54 mm, left atrial area >24 cm(2), rheumatic valve disease and NYHA class were associated with persistence of AF. At Cox regression multivariate analysis, increased left atrial area (OR 1.07 per unit increase-95 % CI 1.01-1.131) and rheumatic aetiology of valve disease (OR 4.52, 95 % CI 1.65-12.4) were associated with persistence of AF at hospital discharge. Persistence of AF after RF ablation in patients undergoing mitral valve surgery is related to aetiology, e.g. rheumatic valve disease, and to increasing left atrial diameter. Due to low rate of late recovery of sinus rhythm, indication to RF ablation associated with MV surgery should be carefully considered in patients with large atria and rheumatic mitral valve disease.

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Efficacy of Surgical Ablation of Atrial Fibrillation in Patients With Rheumatic Heart Disease

Cited by 9 publications

References 19 publications

Concomitant Unipolar Radiofrequency Ablation of Nonparoxysmal Atrial Fibrillation in Rheumatic and Degenerative Valve Disease

Concomitant Unipolar Radiofrequency Ablation of Nonparoxysmal Atrial Fibrillation in Rheumatic and Degenerative Valve Disease

Radiofrequency Ablation of Left Atrial Reentrant Tachycardias in Rheumatic Mitral Valve Disease: A Case Series

Factors related to sinus rhythm at discharge after radiofrequency ablation of permanent atrial fibrillation in patients undergoing mitral valve surgery

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