Surgical treatment of atrial fibrillation in patients with rheumatic valve disease
Rev. bras. cir. cardiovasc
;
32(3): 202-209, May-June 2017. tab, graf
Article
in English
| LILACS
| ID: biblio-897907
ABSTRACT
Abstract Objective:
To 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.Methods:
Retrospective 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.Results:
After 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%.Conclusion:
Atrial 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.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Rheumatic Heart Disease
/
Atrial Fibrillation
/
Heart Valve Diseases
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Rev. bras. cir. cardiovasc
Journal subject:
Cardiology
/
General Surgery
Year:
2017
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Instituto Nacional de Cardiologia/BR
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