Surgical ablation in rheumatic heart disease-Uncharted territory.

BACKGROUND

Atrial fibrillation is a common arrhythmia with a large impact on society and on patients. Rheumatic valve disease is still prevalent in low- and medium-income countries. Performing surgical ablation during surgery for mitral valve disease has been shown to restore sinus rhythm in most patients.

AIMS, MATERIALS AND

METHODS

In this issue of the Journal of Cardiac Surgery, Ma et al., publish a meta-analysis of surgical ablation in patients with rheumatic heart disease (RHD).

RESULTS

They found no difference in short-term outcomes with a higher incidence of restoration to sinus rhythm. In mid- to long-term follow-up, there was no difference in mortality with a signal towards more permanent pacemaker implantation.

DISCUSSION AND

CONCLUSION

Despite some inherent limitations and some methodological flows, this meta-analysis has important insights and is valuable for surgeons taking care of patients with RHD.