Safety and effectiveness of catheter ablation of atrial fibrillation in patients with mitral valve replacement mechanical versus bioprosthetic valves.

This study aims to investigate if there is a difference in the safety and efficacy of catheter ablation of atrial fibrillation (AF) between patients with bioprosthetic mitral valve replacement (MVR) and those with mechanical MVR. A total of 23,794 patients who underwent the first-time catheter ablation of AF were screened. Patients with a history of surgical AF ablation, left atrial appendage closure, or resection were excluded from the study. There were 21 patients in the bioprosthetic MVR group and 85 patients in the mechanical MVR group were included in the study. After a median follow-up of 17.9 (14.4, 21.4) months, AF recurrence rates were similar between the two groups (52.4% vs. 50.6%, log-rank p = 0.527). Persistent AF was independently associated with AF recurrence (HR 1.83, [95% CI 1.00-3.33], p < 0.05). Mitral isthmus block rates were 78.6% in the bioprosthetic MVR group and 69.6% in the mechanical MVR group (p = 0.508). No instances of catheter entrapment were reported in this study. Two pseudoaneurysm and one acute cerebral infarction occurred in the mechanical MVR group. The safety and effectiveness of AF catheter ablation were comparable between patients with mechanical MVR and those with bioprosthetic MVR.