Long-term follow-up of cardiac rhythm after percutaneous mitral balloon valvotomy. Does atrial fibrillation persist?

• Published in: Europace (London, England) England), 2003-01, Vol.5 (1), p.47-53
• Main Authors: Langerveld, J, van Hemel, N M, Kelder, J C, Ernst, J M P G, Plokker, H W M, Jaarsma, W
• Format: Article
• Language: English
• Subjects: Atrial Fibrillation - physiopathology; Catheterization; Female; Follow-Up Studies; Heart Rate; Humans; Male; Middle Aged; Mitral Valve Stenosis - therapy; Retrospective Studies; Time Factors
• ISSN: 1099-5129
• DOI: 10.1053/eupc.2002.0286

Little information is available about short-term and none about long-term follow-up of cardiac rhythm after percutaneous mitral balloon valvotomy (PTMV). We studied the long-term course of the supraventricular rhythm in 137 consecutive patients with severe mitral stenosis, who underwent PTMV. The rhythm before PTMV was sinus rhythm (SR) in 55% and chronic AF in 45% of patients. The mean follow-up time was 3.7+/-2.5 years (n=126). In patients with SR before PTMV, SR persisted in 91% of patients at the end of follow-up. In patients with chronic AF before PTMV, 84% of these patients were still in chronic AF at the end of follow-up, spontaneous conversion to SR did not occur. In 12 of 14 patients (85%), selected for cardioversion, SR was achieved, by DC cardioversion (n=11) or by drugs alone (n=1). After 2 years this outcome persisted, but after 4 years only 38% remained in SR. Pre-procedural SR will persist following PTMV. However in patients with chronic AF PTMV is not associated with reversion to SR, suggesting that measures should be undertaken to restore sinus rhythm.