Atrial fibrillation in the patient undergoing mitral valve surgery: A once-in-a-lifetime opportunity

Gillinov, Marc; Soltesz, Edward G.

doi:10.1016/j.jtcvs.2017.09.125

Cited by 4 publications

(4 citation statements)

References 1 publication

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“…Presence of both atrial fibrillation and HFrEF is associated with a higher risk of hospitalization, stroke, myocardial infarction, renal failure and death than in patients with either condition in isolation (72,73). About 50% of patients presenting for mitral valve surgery have atrial fibrillation (74,75). In comparison, a history of atrial fibrillation is present in 21-54% of LVAD patients (72,(76)(77)(78)(79).…”

Section: Intervention For Atrial Fibrillation During Left Ventricular...mentioning

confidence: 99%

Role of the mitral valve in left ventricular assist device pathophysiology

Noly

Duggal²,

Jiang³

et al. 2022

Front. Cardiovasc. Med.

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Functional mitral regurgitation (MR) in the setting of heart failure results from progressive dilatation of the left ventricle (LV) and mitral annulus. This leads to leaflet tethering with posterior displacement. Contrary to common assumptions, MR often does not resolve with LVAD decompression of the LV alone. The negative impact of significant (moderate-severe) mitral regurgitation in the LVAD setting is becoming better recognized in terms of its harmful effect on right heart function, pulmonary vascular resistance and hospital readmissions. However, controversies remain regarding the threshold for intervention and management. At present, there are no consensus indications for the repair of significant mitral regurgitation at the time of LVAD implantation due to the conflicting data regarding potential adverse effects of MR on clinical outcomes. In this review, we summarize the current understanding of MR pathophysiology in patients supported with LVAD and potential future management strategies.

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Section: Intervention For Atrial Fibrillation During Left Ventricular...mentioning

confidence: 99%

Role of the mitral valve in left ventricular assist device pathophysiology

Noly

Duggal²,

Jiang³

et al. 2022

Front. Cardiovasc. Med.

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“…Радиочастотная абляция (РЧА) ЛП, ПП и ЛВ остается одним из "золотых методов" хирургического лечения ФП при открытых хирургических вмешательствах на сердце и имеет благоприятный клинический прогноз у этой категории пациентов [3,14,16,17,19 ].…”

Section: Functional Assessment Of Left Atrium By Echocardiography Aft...unclassified

Functional assessment of left atrium by echocardiography after radiofrequency ablation of pulmonary vein ostia and left atrium at patients with surgical treatment of atrial fibrillation and mitral valve replacement

Sungatullin

Abdulyanov

Vagizov

et al. 2022

Medicinskaâ vizualizaciâ

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Material and methods. A prospective, randomized, single-center study was conducted. It included 166 patients with mitral valve disease divided into three groups depending on types of AF: with paroxysmal AF at 14 (8.4%) patients, with persistent AF at 63 (37, 9%) patients and with long-term persistent AF at 89 (53.6%) patients hospitalized at the Interregional Clinic and Diagnostic Center Kazan from 2011 to 2018. An average age of patients was 57 ± 5 years old, mainly females amounted to 97 (58.4%).Results. Surgical isolation of the pulmonary vein ostia and the left atrium by RFA at mitral valve replacement significantly improves the contractile function of the left atrium, which allows us to judge about the improvement of the transport function of the left heart chambers as a whole.

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“…Atrial fibrillation (AF) is the most common progressive arrhythmia in the world, which is the main cause of increased risk of stroke, heart failure, peripheral vascular embolism, and other diseases worldwide (1)(2)(3)(4). Especially, in patients undergoing mitral valve surgery, the incidence of AF can be as high as 50-80% (5,6). For this kind of drug-refractory AF, surgery or percutaneous ablation is recommended (7).…”

Section: Introductionmentioning

confidence: 99%

Effect of electrophysiological mapping on non-transmural annulus ablation and atrial fibrillation recurrence prediction after 6 months of Cox-Maze IV procedure

Sun

Fan

Song

et al. 2022

Front. Cardiovasc. Med.

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ObjectiveThe objective of this study was to observe the safety and efficacy of electrophysiological mapping following the Cox-Maze IV procedure and to investigate whether a correlation exists between recurrence of atrial fibrillation (AF) with the completeness of bidirectional electrical isolation and the inducibility of AF immediately after the Cox-Maze IV procedure.MethodsTotally, 80 consecutive patients who suffered from aortic valve or mitral valve disease and persistent AF were randomly enrolled into the control group and electrophysiological mapping following the Cox-Maze IV group (Electrophysio-Maze group). In the Electrophysio-Maze group, patients underwent concomitant Cox-Maze procedure and following electrophysiological mapping of ablation lines in mitral isthmus, left atrial “box,” and tricuspid annulus. If the bidirectional electrical isolation of tricuspid annulus ablation line is incomplete, whether to implement supplementary ablation will be independently decided by the operator. Before and after the Cox-Maze IV procedure, AF induction was performed. All patients in both groups were continuously followed-up and underwent electrocardiogram Holter monitoring after 6 months.ResultsIn total, 42 Electrophysio-Maze patients and 38 controls were enrolled. Compared with patients in the control group, there were shorter hospital stay, better cardiac remodeling changes, and higher relief from AF during the follow-up period of 6 months in the Electrophysio-Maze group. Within the Electrophysio-Maze group, the rate of incomplete the bidirectional electrical isolation of “box” ablation lines was zero, and the rate of incomplete bidirectional electrical isolation of mitral isthmus ablation line or tricuspid annulus ablation line was 23.8%. After two cases of successful complementary ablation on the tricuspid annulus ablation line, the final incomplete bidirectional electrical isolation of annulus ablation lines was 19.0%. There were correlations between late AF recurrence after 6 months with incomplete bidirectional electrical isolation of annulus ablation lines and AF induction immediately after the Cox-Maze IV procedure.ConclusionElectrophysiological mapping following the Cox-Maze procedure is safe and effective. Electrophysiological mapping in the Cox-Maze procedure can find out the non-transmural annulus ablation lines by assessing the completeness of bidirectional electrical isolation of ablation lines, guide supplementary ablation, and predict AF recurrence after 6 months.

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Atrial fibrillation in the patient undergoing mitral valve surgery: A once-in-a-lifetime opportunity

Cited by 4 publications

References 1 publication

Role of the mitral valve in left ventricular assist device pathophysiology

Role of the mitral valve in left ventricular assist device pathophysiology

Functional assessment of left atrium by echocardiography after radiofrequency ablation of pulmonary vein ostia and left atrium at patients with surgical treatment of atrial fibrillation and mitral valve replacement

Effect of electrophysiological mapping on non-transmural annulus ablation and atrial fibrillation recurrence prediction after 6 months of Cox-Maze IV procedure

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