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Ann Thorac Surg 2000;69:1647-1648
© 2000 The Society of Thoracic Surgeons

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Correspondence

Predictive factors for persistence of atrial fibrillation after mitral valve operation

^a Transplant Unit, Papworth Hospital, Papworth Everard, Cambridgeshire CB3 8RE, United Kingdom

To the Editor

We read with great interest the article on the prediction of spontaneous cardioversion after mitral valve surgery [1]. Soon after the introduction of the Maze procedure by Cox and associates [2], we began to investigate the role of this operation in patients with mitral valve disease [3]. Our main objective was to identify factors that could predict which patient with atrial fibrillation would spontaneously cardiovert to decide who would benefit from the addition of the maze procedure to mitral valve surgery. We found that patients with mitral stenosis as opposed to regurgitation were less likely to cardiovert. Also, much to our surprise, left atrial size had no significant predictive power. We are delighted that both of these statements were confirmed by Kalil and his colleagues [1]. However, they state that left ventricular function has no predictive value in this regard. The relation between left ventricular function and the outcome of atrial arrhythmias was suggested by Crijns and colleagues [4]. In keeping with that, we found that left ventricular end-systolic diameter was powerfully associated with late postoperative rhythm following mitral repair [3]. We are particularly interested in Kalil and colleagues [1] findings of preoperative left ventricular end systolic dimension and any present or lack of association with subsequent late atrial rhythm following mitral reconstructive surgery.

References

1. Kalil R.A., Maratia C.B., D’Avila A., Ludwig F.B. Predictive factors for persistence of atrial fibrillation after mitral valve operation. Ann Thorac Surg 1999;67:614-617.[Abstract/Free Full Text]
2. Cox J.L., Schuessler R.B., D’Agostino H.J. The surgical treatment of atrial fibrillation III. Development of a definitive surgical procedure. J Thorac Cardiovasc Surg 1991;101:569-583.[Abstract]
3. Large S.R., Hosseinpour A.R., Wisbey C., Wells F.C. Spontaneous cardioversion and mitral valve repair. Eur J Cardiothorac Surg 1997;11:76-80.[Abstract]
4. Crijns H.J., Van Gelder I.C., Tieleman R.G., et al. Long-term outcome of electrical cardioversion in patients with chronic atrial flutter. Heart 1997;77:56-61.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Large, S. R. Articles by Hosseinpour, A.-R. Search for Related Content PubMed Articles by Large, S. R. Articles by Hosseinpour, A.-R.