Ashwal A Jayaram1, Anand N Shukla2, Saurin Shah3, Vidya Nayak4, Sridevi Prabhu4, Umesh Pai4. 1. Assistant Professor, Department of Cardiology, Kasturba Medical College, Manipal University , Manipal, Karnataka, India . 2. Associate Professor, Department of Cardiology, U.N.Mehta Institute of Cardiology and Research Centre , Gujarat, India . 3. Assistant Professor, Department of Cardiology, U.N.Mehta Institute of Cardiology and Research Centre , Gujarat, India . 4. Assistant Professor, Department of CVT, School of Allied Health Sciences, Manipal University , Karnataka, India .
Abstract
INTRODUCTION: Atrial Fibrillation (AF) is largely present in patients with rheumatic valvular disease, leading to hospitalizations. AIM: We aimed to study the restoration and maintenance of Sinus Rhythm (SR) in rheumatic patients with Mitral Stenosis (MS) and AF after Balloon Mitral Valvotomy (BMV) and evaluated the factors which affect the maintenance of SR. MATERIALS AND METHODS: A total of 50 patients who underwent BMV at U. N. Mehta Institute of Cardiology and Research Centre from 2010 November to 2013 January were included in the study. Subsequently, all patients were treated with amiodarone and electrical cardioversion was applied in patients in whom it was necessary. The patients were followed for six months for conversion and maintenance of SR. RESULTS: Total 34 (68%) patients reverted to SR. Twelve patients reverted to SR with amiodarone and 22 patients with electrical cardioversion and amiodarone. Out of the total, 29 patients and 26 patients remained in SR at the end of follow up at 3 months and 6 months respectively. CONCLUSION: Smaller Left Atrial (LA) size and greater Mitral Valve Area (MVA) are the chief predictors of restoration and maintenance of SR. Combining BMV with an aggressive anti-arrhythmic strategy offers the best prospect of rhythm control.
INTRODUCTION:Atrial Fibrillation (AF) is largely present in patients with rheumatic valvular disease, leading to hospitalizations. AIM: We aimed to study the restoration and maintenance of Sinus Rhythm (SR) in rheumaticpatients with Mitral Stenosis (MS) and AF after Balloon Mitral Valvotomy (BMV) and evaluated the factors which affect the maintenance of SR. MATERIALS AND METHODS: A total of 50 patients who underwent BMV at U. N. Mehta Institute of Cardiology and Research Centre from 2010 November to 2013 January were included in the study. Subsequently, all patients were treated with amiodarone and electrical cardioversion was applied in patients in whom it was necessary. The patients were followed for six months for conversion and maintenance of SR. RESULTS: Total 34 (68%) patients reverted to SR. Twelve patients reverted to SR with amiodarone and 22 patients with electrical cardioversion and amiodarone. Out of the total, 29 patients and 26 patients remained in SR at the end of follow up at 3 months and 6 months respectively. CONCLUSION: Smaller Left Atrial (LA) size and greater Mitral Valve Area (MVA) are the chief predictors of restoration and maintenance of SR. Combining BMV with an aggressive anti-arrhythmic strategy offers the best prospect of rhythm control.
Authors: Anan A Abu Rmilah; Mahmoud A Tahboub; Adham K Alkurashi; Suhaib A Jaber; Asil H Yagmour; Deema Al-Souri; Bradley R Lewis; Vuyisile T Nkomo; Patricia J Erwin; Guy S Reeder Journal: Int J Cardiol Heart Vasc Date: 2021-04-01