Abstract
Introduction: Atrial fibrillation (AF) is the most common arrhythmia in patients with mitral stenosis (MS) and it may increase complications and decreases success rates of percutaneous balloon mitral valvotomy (PBMV). This study aimed to investigate the short and long term results of PBMV in patients with AF compared to sinus rhythm (SR). Methods: In this cross sectional study, 1000 patients with MS who had undergone PBMV between 1999 and 2013 were enrolled including 585 and 415 patients with AF and SR respectively. Patients were followed for a mean of 7.27 ± 3.16 years. Clinical, echocardiographic and hemodynamic data were collected. Procedure success, in-hospital and long-term outcome were evaluated. Results: Patients with AF were older and had greater symptoms, mitral regurgitation, mitral echocardiographic score, and mitral pressure gradient before PBMV. PBMV success rate were significantly lower in AF group (P < 0.001). In-hospital complications, including severe mitral regurgitation, emergency mitral valve surgery, peripheral embolism and long-term complications, including mortality, re-valvotomy, mitral replacement surgery and peripheral embolism/stroke were significantly higher in patients with AF. Conclusion: AF leads to worse in-hospital and long-term outcome and lower PBMV success rate. Repeated assessment and early decision to PBMV in patients with MS to reduce AF and AF related complication seems necessary.
Highlights
Atrial fibrillation (AF) is the most common arrhythmia in patients with mitral stenosis (MS) and it may increase complications and decreases success rates of percutaneous balloon mitral valvotomy (PBMV)
Considering that the previous studies have been conducted on a smaller number of patients, this study aimed at investigating the immediate success rates of PBMV, short and long term results, and mortality risk in patients with MS and AF compared to sinus rhythm (SR) in a large data base
Demographic variables such as age, gender and clinical variables, including the severity of dyspnea according to New York Heart Association functional class (NYHA-FC), echocardiographic variables including MS echocardiographic score, and the mitral valve area (MVA) before and after PBMV and hemodynamic variables such as mean left atrial pressure (LAP), mean transmitral pressure gradient and pulmonary artery systolic pressure levels were checked and the results were compared between the two groups
Summary
Atrial fibrillation (AF) is the most common arrhythmia in patients with mitral stenosis (MS) and it may increase complications and decreases success rates of percutaneous balloon mitral valvotomy (PBMV). Mitral stenosis (MS) is still a public health problem in developing countries.[1,2] Percutaneous balloon mitral valvotomy (PBMV) is performed as preferred alternative to surgery for most patients with hemodynamically significant MS.[3,4,5,6,7,8,9] Atrial fibrillation (AF) is the most common arrhythmia that occurs in 40%-75% of symptomatic patients with MS.[10,11] Several studies have shown that AF affects short and long term outcomes and the mortality risk of PBMV and in most cases it has been associated with a decreased success rate of PBMV and a worse clinical outcome.[12,13,14,15,16,17,18] So considering that the previous studies have been conducted on a smaller number of patients, this study aimed at investigating the immediate success rates of PBMV, short and long term results, and mortality risk in patients with MS and AF compared to sinus rhythm (SR) in a large data base
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
