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

Background: This study aims to examine the effects of amiodarone versus propafenone for maintenance of stable sinus rhythm after left atrial bipolar radiofrequency ablation combined with a mitral valve procedure in patients with mitral valve disease and persistent atrial fibrillation. Methods: The study included 75 patients (29 males, 46 females; mean age 66,8±7.4 years; range 54 to 82 years) who underwent left atrial bipolar radiofrequency ablation combined with mitral valve surgery between July 2008 and July 2010. Patients were divided into three groups of 25: propafenone group (group 1), amiodarone group (group 2), and control group (group 3). Atrial fibrillation patients with slow ventricular response were excluded from the study. Results: Data was collected at preoperative period, during surgery, prior to discharge from hospital, and at 3, 6, and 18 months after discharge. Patients from all groups were followed for 18 months. In group 1, the number of patients in sinus rhythm was 22 at discharge, 20 at three months, and 21 at six and 18 months. In group 2, the number of patients in sinus rhythm was 18 at discharge, 13 at three months, 15 at six months, and 16 at 18 months. In group 3, the number of patients in sinus rhythm was 16 at discharge, 11 at three months, 12 at six months, and 14 at 18 months. Group 1 had a statistically significantly higher rate of stable sinus rhythm. No hospital mortality was observed in any group. Conclusion: This study revealed that propafenone was more effective than amiodarone in maintenance of stable sinus rhythm at the postoperative period in patients who underwent bipolar radiofrequency ablation combined with a mitral valve procedure.