Objective:Atrial fibrillation (AF) is the most formidable supraventricular tachyarrhythmia, which worsens the natural course of mitral valve disease. In this study, we evaluated early and long-term results and quality of life (QOL) after simultaneous surgical radiofrequency ablation (RFA) of AF, left atrial reduction and mitral valve repair or replacement.Methods:Overall, 147 patients with mitral valve diseases who underwent mitral valve surgery were included in this prospective cohort study. Patients were divided into two groups according to the type of operation: the study group—patients after mitral valve surgery with concomitant radiofrequency surgical ablation and left atrial reduction procedure (54 patients), and the control group—patients undergoing only mitral valve surgery (93 cases). We assessed AF recurrence and sinus rhythm restoration rates and mortality rates, QOL measures, postoperative complications rates, and left atrial size during follow-up.Results:In the study group, sinus rhythm restoration rate in the early postoperative period was 63%, but at the time of discharge it reduced to 29%; after 6 months, it significantly increased to 72% and after 3 years, to 81% (p=0.02). In the control group, the sinus rhythm restored only in 14% after 1 year, and at 3 years, it was 22%, although in the early postoperative period it, was 43%. Analysis of left atrial size before and after surgery showed that dimension significantly reduced in both groups (study group, p=0.013; control group, p=0.024). In addition, in patients undergoing surgical RFA procedure, there was a significant association between shorter heart disease history (p=0.02) and shorter AF history (p=0.074) with maintenance of sinus rhythm. The mortality rate in the study group was 4% (two patients) and in the control group 5% (five patients). Comparison of QOL measures between study and control groups after 1 year showed that patients undergoing concomitant atrial reduction surgery and RFA had significant improvement of QOL physical (p=0.03) and role (p=0.03) functioning, heartbeat (p=0.01), general (p=0.03) and mental health (p=0.01), vitality (p=0.007), and social role (p=0.02) functioning measures as compared to preoperative state, being higher than in patients who underwent only mitral valve surgery.Conclusion:Application of surgical RFA using irrigated cooling electrode and atrial reduction during mitral valve surgery is associated with higher restoration and maintenance of SR as compared to patients undergoing only mitral valve surgery. We did not observe complications related to AF surgery that required permanent pacemaker implantation. Performing concomitant surgery as surgical RFA, atrial reduction along with mitral valve surgery, improves QOL in the short- and long-term and reduces the feeling of heartbeat and discomfort. (Anatol J Cardiol 2016; 16: 797-803)

Introduction: Acute myocardial infarction (AMI) remains one of the leading causes of death worldwide during cardiovascular diseases. An important step in the secondary prevention of recurrent myocardial infarction is cardiac rehabilitation (CR). However, with the onset of the global COVID-19 pandemic, the CR programs in many clinics were limited due to the quarantine measures. Knowledge about the effects of CR on quality of life and exercise tolerance in AMI patients with COVID is scarce. Aim: To evaluate the use of a modular CR program on quality of life and exercise tolerance among post-AMI patients with COVID-19 recovery, and in those with no history of COVID-19 infection. Material and methods: This study included 118 patients with or recovering from acute myocardial infarction. They were divided into 2 groups: the first group included 86 patients, who had slight "ground-glass opacity" changes on the computed tomography (CT) scans, and the second group comprised 32 patients, who had no history of coronavirus infection or no change on CT scan of the lungs during the pandemic. The CR program was modified due to the pandemic era. Results: Physical tolerance increased in both groups after CR 3.6 months as compared to before the CR program (duration of training in seconds (p < 0.05), a 6-minute walk test (p < 0.05), the maximal oxygen consumption (VO2max) (p < 0.05), and the metabolic equivalent of task (MET) (p < 0.05)). Similarly, quality of life measures improved in both groups. Treatment satisfaction was higher in the first group at the beginning and the end of CR. Conclusions: The modular CR program improves exercise capacity and quality of life with AMI and COVID-19 similar to that of patients without AMI. Patients after COVID-19 should undergo rehabilitation

Funding Acknowledgements Type of funding sources: None. Introduction Patients after open heart surgery require cardiac rehabilitation (CR), as reconstructive surgery reduces the quality of life. A perioperative EuroSCORE II score is used for assessment of risk of worse outcomes after surgery. Few is known whether CR is feasible in patients undergoing open heart surgery with moderate and high risk Euroscore II and whether the intensity of physical activity (PA) varies according to the type of heart surgery. Objective To evaluate effect of CR on perceived intensity of PA and target heart rate in patients who underwent open heart surgery and different EurSCORE II scale. Methods The retrospective cohort study included 104 patients who underwent open heart surgery and stage 2 CR: group 1- 64 patients with coronary artery bypass surgery (CABG), group 2 - 40 patients with valvular heart disease (VHD) surgery. We evaluated following parameters: subjective assessment of PA intensity on the Borg scale and objective assessment on the achievement of the training heart rate before and after CR. The perioperative risk of worse outcomes was assessed using EuroSCORE II scale. Results According to the EuroSCORE II scale: 1st group patients were at: -low risk -21%, moderate risk -68%, high risk -11% and 2nd group - low risk 29%, moderate risk 54%, and high risk 17%. None of patients had adverse effects of CR. In the first group, the subjective assessment on the Borg scale before CR was slightly higher than in the second group: -2.43 ± 0.09 points vs. 2.22 ± 0.11 points before CR. At the end of the CR, there was a significant increase (p&lt;0.05) in perception of intensity of PA in both groups - the 1st group –4.37 ± 0.06 points and in 2nd group - 4.35 ± 0.07 points. Target heart rate before CR did not differ between groups: group 1 - 75 ± 5.7 beats per minute and group 2 - 89 ± 7.7 beats per minute (p=0.552): after CR there was a significant decrease in heart rate: group 1 - 55 ± 2.2 bpm, group 2 - 61 ± 3.2 bpm (p =.0012). Conclusion 1. CR increases significantly intensity of physical activity in pts after open heart surgery 2. Though the VHD surgery pts might have lower intensity of PA before CR, the intensity of PA after CR did not differ between CABG and VHD surgeries, increasing in both groups. 3. Patients with moderate and high EurSCORE II risk comprised 80 and 69% of patients in our cohort, none of them experienced adverse effect of CR and had improvement of PA and achieved target heart rate.