Percutaneous Transvenous Mitral Commissurotomy and Radiofrequency Catheter Ablation in Patients With Mitral Stenosis Initial Experience and Results

BACKGROUND: The purpose of this study was to evaluate the short- and long-term results of radiofrequency catheter ablation (RFCA) for the treatment of atrial fibrillation (AF) in patients with mitral stenosis (MS) following percutaneous transvenous mitral commissurotomy (PTMC). METHODS AND RESULTS: Four patients (2 males, age 59+/-6 years) underwent simultaneous PTMC and pulmonary vein (PV) ablation. All patient had AF and MS (2 had persistent AF >1 month, 2 had paroxysmal AF), and the mean duration of AF was 3.4+/-3.3 years. The mean left atrial dimension was 47+/-7 mm and the mean ejection fraction was 58+/-4%. After PTMC, RFCA was performed in all patients (3 underwent PV isolation and 1 had PV focal ablation). The mitral valve area increased from 1.11 +/-0.19 to 1.90+/-0.20 cm(2) (p < 0.01). The frequency of AF episodes was dramatically reduced in the 2 patients with paroxysmal AF, and the 1 with persistent AF maintained sinus rhythm, but 1 patient with persistent AF developed recurrent AF. No complications or cardiac events occurred in any of the patients. CONCLUSION: The combination of RFCA and PTMC was safe and feasible, and may be useful in patients with MS and AF.