Abstract
ObjectiveTo assess heart rhythm and predictive factors associated with sinus rhythm after one year in patients with rheumatic valve disease undergoing concomitant surgical treatment of atrial fibrillation. Operative mortality, survival and occurrence of stroke after one year were also evaluated.MethodsRetrospective longitudinal observational study of 103 patients undergoing rheumatic mitral valve surgery and ablation of atrial fibrillation using uni- or bipolar radiofrequency between January 2013 and December 2014. Age, gender, functional class (NYHA), type of atrial fibrillation, EuroSCORE, duration of atrial fibrillation, stroke, left atrial size, left ventricular ejection fraction, cardiopulmonary bypass time, myocardial ischemia time and type of radiofrequency were investigated.ResultsAfter one year, 66.3% of patients were in sinus rhythm. Sinus rhythm at hospital discharge, lower left atrial size in the preoperative period and bipolar radiofrequency were associated with a greater chance of sinus rhythm after one year. Operative mortality was 7.7%. Survival rate after one year was 92.3% and occurrence of stroke was 1%.ConclusionAtrial fibrillation ablation surgery with surgical approach of rheumatic mitral valve resulted in 63.1% patients in sinus rhythm after one year. Discharge from hospital in sinus rhythm was a predictor of maintenance of this rhythm. Increased left atrium and use of unipolar radiofrequency were associated with lower chance of sinus rhythm. Operative mortality rate of 7.7% and survival and stroke-free survival contribute to excellent care results for this approach.
Highlights
Atrial fibrillation (AF) is the most common sustained arrhythmia in the United States, where a prevalence of 2.2 million people with AF is estimated[1,2]
Atrial fibrillation ablation surgery with surgical approach of rheumatic mitral valve resulted in 63.1% patients in sinus rhythm after one year
Increased left atrium and use of unipolar radiofrequency were associated with lower chance of sinus rhythm
Summary
Atrial fibrillation (AF) is the most common sustained arrhythmia in the United States, where a prevalence of 2.2 million people with AF is estimated[1,2]. The prevalence of AF increases with age. It is estimated that the incidence of AF doubles for each decade of adult life. AF affects 2.3% of individuals over 40 years and 5.9% of those over 65 years[1]. 70% of individuals diagnosed with AF are between 65 and 80 years old[1]. It can be considered an important risk factor for stroke[3]
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