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Stefano Forlani
Ruggero De Paulis
Lorenzo Guerrieri Wolf
Patrizio Polisca
Marco Moscarelli
Luigi Chiariello
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Right arrow Electrophysiology - arrhythmias

Ann Thorac Surg 2006;81:863-867
© 2006 The Society of Thoracic Surgeons

Original article: Cardiovascular

Conversion to Sinus Rhythm by Ablation Improves Quality of Life in Patients Submitted to Mitral Valve Surgery

Stefano Forlani, MD, PhD * , Ruggero De Paulis, MD, Lorenzo Guerrieri Wolf, MD, Renata Greco, MD, Patrizio Polisca, MD, Marco Moscarelli, MD, Luigi Chiariello, MD

Division of Cardiac Surgery, University of Rome, Tor Vergata, Rome, Italy

Accepted for publication September 1, 2005.

* Address correspondence to Dr Forlani, Divisione di Cardiochirurgia, Università di Roma Tor Vergata, Policlinico di Tor Vergata, V.le Oxford 81, Rome, 00133 Italy (Email: stefanoforlani{at}gmail.com).

BACKGROUND: Atrial fibrillation can be successfully treated with surgical ablation, but the effect of restoring sinus rhythm on the quality of life has yet to be established. We evaluate the effects of left atrial ablation combined with mitral valve surgery on health-related quality of life in patients with permanent atrial fibrillation.

METHODS: Ninety-one consecutive patients with permanent atrial fibrillation underwent mitral valve surgery at our division. The last 53 also received left atrial ablation by means of monopolar radiofrequency and excision of the left appendage. The patients were divided into two groups according to the median total score obtained at the Short Form 36 Health Survey used to evaluate their quality of life (ie, the good quality of life group [n = 54] and the poor quality of life group [n = 37]).

RESULTS: Preoperative and intraoperative data of the two groups were similar. In-hospital mortality and morbidity were similar in both groups. Sinus rhythm was obtained in 68% of patients (36 of 53) treated with left atrial ablation and it occurred spontaneously in 10% of patients (4 of 38) treated for the mitral pathology only. At follow-up, there was no difference between the groups in ejection fraction, left atrial diameter, mitral dysfunction, tricuspidal regurgitation, and New York Heart Association functional class. Using stepwise logistic regression, only the presence of sinus rhythm was associated with better quality of life.

CONCLUSIONS: In patients submitted to mitral surgery, conversion to sinus rhythm by left atrial ablation can significantly improve the health-related quality of life.




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