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Preoperative predictors of recurrent atrial fibrillation late after successful mitral valve reconstruction

Vogt, P.R. ; Brunner-LaRocca, H.P. ; Rist, M. ; Zünd, G. ; Genoni, M. ; Lachat, M. ; Niederhäuser, U. ; Turina, M.I.

In: European Journal of Cardio-Thoracic Surgery, 1998, vol. 13, no. 6, p. 619-624

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    Titre
    • Preoperative predictors of recurrent atrial fibrillation late after successful mitral valve reconstruction
    Auteur
    • Vogt, P.R.. Clinic for Cardiovascular Surgery, University Hospital, Ramistrasse 100, 8091 Zurich, Switzerland
    • Brunner-LaRocca, H.P.. Clinic for Cardiovascular Cardiology, University Hospital, Ramistrasse 100, 8091 Zurich, Switzerland
    • Rist, M.. Clinic for Cardiovascular Surgery, University Hospital, Ramistrasse 100, 8091 Zurich, Switzerland
    • Zünd, G.. Clinic for Cardiovascular Surgery, University Hospital, Ramistrasse 100, 8091 Zurich, Switzerland
    • Genoni, M.. Clinic for Cardiovascular Surgery, University Hospital, Ramistrasse 100, 8091 Zurich, Switzerland
    • Lachat, M.. Clinic for Cardiovascular Surgery, University Hospital, Ramistrasse 100, 8091 Zurich, Switzerland
    • Niederhäuser, U.. Clinic for Cardiovascular Surgery, University Hospital, Ramistrasse 100, 8091 Zurich, Switzerland
    • Turina, M.I.. Clinic for Cardiovascular Surgery, University Hospital, Ramistrasse 100, 8091 Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Journal of Cardio-Thoracic Surgery, 1998, vol. 13, no. 6, p. 619-624. Elsevier Science B.V.
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:292934
    Summary
    Objective: Late outcome after mitral valve repair was examined to define preoperative predictors of recurrent atrial fibrillation late after successful mitral valve reconstruction. Methods: One hundred and eighty-nine patients, 112 with preoperative sinus rhythm and 72 with preoperative chronic or intermittent atrial fibrillation, were followed for 12.2±10 years after valve repair. Clinic, hemodynamic end echocardiographic data were entered into Cox-regression and Kaplan-Meyer analysis to assess predictors for recurrent atrial fibrillation late after successful mitral valve repair. Results: Univariate and multivariate predictors for recurrent atrial fibrillation late after successful mitral valve reconstruction were preoperative atrial fibrillation (P=0.0001), preoperative antiarrhythmic drug treatment (P=0.005), heart rate (P=0.01), left ventricular ejection fraction (P=0.01) and increased left ventricular posterior wall thickness (P=0.05). Patients>57.5 years with a mean pulmonary artery pressure ≥23mm Hg and a history of preoperative antiarrhythmic drug treatment had an odds ratio of 53.33 (95% confidence limits 6.12-464.54) for atrial fibrillation late after successful mitral valve repair. Conclusion: Older patients with a history of atrial fibrillation, antiarrhythmic treatment or an elevated pulmonary artery pressure may present atrial fibrillation late after successful mitral valve repair. They could be considered for combined mitral valve reconstruction and surgery for atrial fibrillation even though sinus rhythm is present preoperatively