Arrhythmias following Cardiac Valve Replacement

Smith, R. Neal; Grossman, William; Johnson, Lewis W.; Segal, Herman; Collins, John J.; Dalen, James E.

doi:10.1161/01.cir.45.5.1018

Cited by 36 publications

(6 citation statements)

References 7 publications

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“…The incidence of AF in hospitalized patients was reported to be 24% by Goldman 13. Smith et al14 and Stephenson et al15 reported an AF incidence rate of 10% after cardiac valve surgery and open heart surgery. The highest incidence reported was 65% by Mathew et al16 but the incidence of AF after coronary artery bypass graft surgery is much lower, ranging from 3.3% to 30% 16,17.…”

Section: Resultsmentioning

confidence: 99%

Predictors of Atrial Fibrillation following Coronary Artery Bypass Grafting

Sabzi

Zokaei

Moloudi

2011

Clin Med Insights Cardiol

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Background:Atrial fibrillation (AF) is a frequent and serious complication of coronary artery bypass graft (CABG) surgery.Methods:We undertook a retrospective review of the records of patients undergoing CABG at Imam Ali Hospital between February 1, 2003 and February 1, 2006. The patients were divided in two groups, ie, Group A (AF) and Group B (no AF). The association between the occurrence of AF following CABG and other variables was compared with respect to continuous or categorical variables by t-test and χ2-test.Results:Multivariate logistic regression analysis of potentially predictive factors in univariate analysis showed that opium use, type of operation, and crossclamp time were predictors of AF following CABG.Conclusion:This study identifies some new predictors of postoperative AF, control of which could lead to a lower incidence of AF and reduced morbidity, mortality, and resource utilization for patients undergoing cardiac surgery.

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Section: Resultsmentioning

confidence: 99%

Predictors of Atrial Fibrillation following Coronary Artery Bypass Grafting

Sabzi

Zokaei

Moloudi

2011

Clin Med Insights Cardiol

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“…Our methods did not permit us to establish the incidence of VA following AVI. Limited data concerning acute postoperative VA reports a varied incidence ranging from 0.74% to 21% 5,6 . Yet, VA can present years following surgical intervention, akin to postoperative atrial arrhythmias and post‐myocardial infarction VA 2 .…”

Section: Discussionmentioning

confidence: 99%

“…Limited data concerning acute postoperative VA reports a varied incidence ranging from 0.74% to 21%. 5,6 Yet, VA can present years following surgical intervention, akin to postoperative atrial arrhythmias and postmyocardial infarction VA. 2 indeed, the difference in VA timing related to valve surgery may be due to variation in the arrhythmia mechanism.…”

Section: Follow-up After Va Ablationmentioning

confidence: 99%

Ventricular arrhythmias in patients with prior aortic valve intervention: Characteristics, ablation and outcomes

Khalil

Toya

Ahmad

et al. 2023

Cardiovasc electrophysiol

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Introduction: Data regarding ventricular tachycardia (VT) or premature ventricular complex (PVC) ablation in patients with aortic valve (AV) intervention (AVI) is limited.Catheter ablation (CA) can be challenging given perivalvular substrate in the setting of prosthetic valves. We sought to investigate the characteristics, safety, and outcomes of CA in patients with prior AVI and ventricular arrhythmias (VA).Methods: We identified consecutive patients with prior AVI (replacement or repair) who underwent CA for VT or PVC between 2013 and 2018. We investigated the mechanism of arrhythmia, ablation approach, perioperative complications, and outcomes. Results:We included 34 patients (88% men, mean age 64 ± 10.4 years, left ventricular (LV) ejection fraction 35.2 ± 15.0%) with prior AVI who underwent CA (22 VT; 12 PVC).LV access was obtained through trans-septal approach in all patients except one patient who had percutaneous transapical access. One patient had combined retrograde aortic and trans-septal approach. Scar-related reentry was the dominant mechanism of induced VTs. Two patients had bundle branch reentry VTs. In the VT group, substrate mapping demonstrated heterogeneous scar that involved the peri-AV area in 95%. Despite that, the site of successful ablation included the periaortic region only in 6 (27%) patients. In the PVC group, signal abnormalities consistent with scar in the periaortic area were noted in 4 (33%) patients. In 8 (67%) patients, the successful site of ablation was unrelated to the periaortic area. No procedure-related complications occurred. The survival and recurrence-free survival rate at 1 year tended to be lower in VT group than in PVC group (p = .06 and p = .05, respectively) with a 1-year recurrence-free survival rate of 52.8% and 91.7%, respectively. No arrhythmia-related death was documented on longterm follow-up.Conclusion: CA of VAs can be performed safely and effectively in patients with prior AVI.

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“…Though this study included 749 patients with MVS, the incidence of VT was reported after valve surgery in general. Another study reported that the incidence of VT was 8% in patients with mitral valve replacement compared to 21% with aortic valve replacement 23 . Though these studies evaluated acute incidence, VA can present years following surgical intervention, akin to postoperative atrial flutter and post myocardial infarction ventricular arrhythmias 10 .…”

Section: Discussionmentioning

confidence: 99%

Characteristics and outcomes of ventricular tachycardia and premature ventricular contractions ablation in patients with prior mitral valve surgery

Khalil

Toya

Madhavan

et al. 2022

Cardiovasc electrophysiol

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Background Data regarding ventricular tachycardia (VT) or premature ventricular complex (PVC) ablation following mitral valve surgery (MVS) is limited. Catheter ablation (CA) can be challenging given perivalvular substrate in the setting of mitral annuloplasty or prosthetic valves. Objective To investigate the characteristics, safety, and outcomes of radiofrequency CA in patients with prior MVS and ventricular arrhythmias (VA). Methods We identified consecutive patients with prior MVS who underwent CA for VT or PVC between January 2013 and December 2018. We investigated the mechanism of arrhythmia, ablation approach, peri‐operative complications, and outcomes. Results In our cohort, 31 patients (77% men, mean age 62.3 ± 10.8 years, left ventricular ejection fraction 39.2 ± 13.9%) with prior MVS underwent CA (16 VT; 15 PVC). Access to the left ventricle was via transseptal approach in 17 patients, and a retrograde aortic approach was used in 13 patients. A combined transseptal and retrograde aortic approach was used in one patient, and a percutaneous epicardial approach was combined with trans‐septal approach in one patient. Heterogenous scar regions were present in 94% of VT patients and scar‐related reentry was the dominant mechanism of VT. Forty‐seven percent of PVC patients had abnormal substrate at the site targeted for ablation. Clinical VA substrates involved the peri‐mitral area in six patients with VT and five patients with PVC ablation. No procedure‐related complications were reported. The overall recurrence‐free rate at 1‐year was 72.2%; 67% in the VT group and 78% in the PVC group. No arrhythmia‐related death was documented on long‐term follow‐up. Conclusion CA of VAs can be performed safely and effectively in patients with MVS.

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Arrhythmias following Cardiac Valve Replacement

Cited by 36 publications

References 7 publications

Predictors of Atrial Fibrillation following Coronary Artery Bypass Grafting

Predictors of Atrial Fibrillation following Coronary Artery Bypass Grafting

Ventricular arrhythmias in patients with prior aortic valve intervention: Characteristics, ablation and outcomes

Characteristics and outcomes of ventricular tachycardia and premature ventricular contractions ablation in patients with prior mitral valve surgery

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