What question did this study set out to answer?

To determine the long-term impact of atrial fibrillation and conversion to sinus rhythm on mortality and embolic complications following heart valve surgery.

May 27, 2005European Journal of Cardio-Thoracic SurgeryOpen Access

Conversion to sinus rhythm does not improve long-term survival after valve surgery: insights from a 20-year follow-up study☆

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Why the study?

Does conversion to sinus rhythm improve long-term survival or reduce embolic complications in patients with preoperative atrial fibrillation undergoing valve surgery?

Key Points

To determine the long-term impact of atrial fibrillation and conversion to sinus rhythm on mortality and embolic complications following heart valve surgery.
Prospective cohort study analyzing 5,466 patients who underwent heart valve surgery between 1979 and 2003.
Tracked patient rhythm status, mortality, and embolic complications over up to 20 years of follow-up using annual electrocardiograms.
Patients with preoperative AF had lower 20-year survival than those without (23.7% vs. 33.4%, P<0.0001), but preoperative AF was not an independent predictor of long-term mortality (HR=1.04, P=0.6).
Postoperative conversion to sinus rhythm did not improve mortality among patients with preoperative AF (AF vs. sinus rhythm, HR=1.07, P=0.5709).
New-onset postoperative AF increased mortality in patients with preoperative sinus rhythm (HR=1.46, P=0.0012), whereas mitral valve surgery predicted embolic complications (HR=1.55, P=0.0270).

Structured PICO

Does conversion to sinus rhythm improve long-term survival or reduce embolic complications in patients with preoperative atrial fibrillation undergoing valve surgery?

Population

5466 patients who underwent valve surgery between 1979 and 2003

Intervention

Conversion to sinus rhythm postoperatively

Comparator

Persistent atrial fibrillation postoperatively

Outcome

Long-term mortality and embolic complicationshard clinical

Conversion to sinus rhythm after valve surgery in patients with preoperative AF does not improve long-term survival or reduce embolic complications, suggesting AF may be a marker of advanced disease.

Discussion

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Implication

Caution against targeting sinus rhythm for survival in preoperative AF valve patients; leaves open embolic risk modification.

Cite This Study

Chaput et al. (2005) studied this question.

synapsesocial.com/papers/6a72966235aa2c282ce353eb https://doi.org/10.1016/j.ejcts.2005.03.014

Topics

Atrial fibrillation Persistent AF management Valvular heart disease Anticoagulation in AF AF ablation outcomes

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Conversion to sinus rhythm does not improve long-term survival after valve surgery: insights from a 20-year follow-up study☆

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Conversion to sinus rhythm does not improve long-term survival after valve surgery: insights from a 20-year follow-up study☆

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

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