Key result
Atrial fibrillation surgery during mitral valve surgery effectively restored sinus rhythm at 6 months regardless of left atrial size (94.7% in giant left atrium vs 95.7% in non-giant left atrium).
Why the study?
Does atrial fibrillation surgery effectively induce sinus rhythm and restore left atrial contractile function in patients with mitral valve disease and a giant left atrium compared to those without a giant left atrium?
Cohort (n=188)
Does atrial fibrillation surgery effectively induce sinus rhythm and restore left atrial contractile function in patients with mitral valve disease and a giant left atrium compared to those without a giant left atrium?
Absolute Event Rate: 94.7% vs 95.7%
Atrial fibrillation surgery is highly effective at inducing sinus rhythm and restoring left atrial contractile function during concomitant mitral valve surgery, regardless of left atrial size.
May support AF surgery during mitral valve procedures even with giant left atrium; challenges prior reports of low sinus conversion but remains hypothesis-generating.
OBJECTIVE: The incidence of sinus conversion in the enlarged left atrium after atrial fibrillation surgery is reported to be low. The purpose of the current study was to investigate the effects of atrial fibrillation surgery on mitral valve disease associated with a giant left atrium (GLA). METHOD: From July of 1997 to February of 2002, 188 patients received mitral valve and atrial fibrillation surgery. The patients were placed in either GLA group (n = 94), or NGLA group (n = 94), based on LA size. The presence and onset of sinus rhythm and the incidence and velocity of transmitral A waves were monitored during the early postoperative period and throughout the follow up period of 42 months. RESULTS: The onset of postoperative sinus rhythm was slightly earlier in the NGLA group than in the GLA group at 1.3+/-0.4 days versus 3.1+/-1.2 days, respectively, (P = 0.008). The sinus conversion rates in the GLA and the NGLA groups were 91.5 and 97.9% in the early postoperative period, and 94.7 and 95.7% at 6 months after surgery, respectively. A wave appearance rates in the early postoperative period in the GLA and the NGLA groups were 62.2 and 71.7%, and continued to improve over time to 94 and 95% by 36 months, respectively. Peak A wave velocities in the early postoperative period in GLA and NGLA groups were 67.4+/-34.0 and 61.1+/-29.5 cm/s without significant change during the follow up. CONCLUSION: The results suggest that atrial fibrillation surgery is effective at inducing sinus rhythm and restoring left atrial contractile function after concomitant mitral valve surgery regardless of LA size.
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Choo et al. (2004) conducted a cohort in Atrial fibrillation and mitral valve disease (n=188). Atrial fibrillation surgery in giant left atrium (GLA) vs. Non-giant left atrium (NGLA) was evaluated on Sinus conversion rate at 6 months. Atrial fibrillation surgery during mitral valve surgery effectively restored sinus rhythm at 6 months regardless of left atrial size (94.7% in giant left atrium vs 95.7% in non-giant left atrium).
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