Radiofrequency ablation for atrial fibrillation in rheumatic valvular disease.

BACKGROUND

We have reviewed the results of radiofrequency ablation (RFA) in patients with rheumatic valve disease.

METHODS

Sixty-seven patients underwent operation for rheumatic valvular disease and RFA concomitantly with the planned procedure. Twenty-two (32.8%) were male and 45 (67.2%) female. The mean duration of atrial fibrillation (AF) was 47.4+/-30.4 months (12-192). Logistic regression test was used to perform a risk factor analysis.

RESULTS

Two patients died postoperatively (3.0%) and 3 died in the follow-up period (4.5%). One patient (1.5%) required permanent pacemaker. During the hospitalisation, 24 patients (35.8%) had AF but 6 of them returned to the normal sinus rhythm by the time of discharge. Forty-nine patients (73.1%) were discharged with normal sinus rhythm. The mean duration of follow-up was 15.1+/-15.2 months (0-59). Six patients (9.0%) had recurrent AF during the follow-up period. For early AF recurrence male sex was a significant risk factor (p=0.028) with an odds ratio 8627 (CI 95% 1261-59,006).

CONCLUSIONS

The low sinus rhythm rate at discharge and high rates of recurrence may be attributed to the disease nature. Males are at increased risk of early AF recurrence but no significant risk factors for late recurrence have been found.