Long-term clinical outcome of atrial fibrillation ablation in patients with history of mitral valve surgery
AimsAtrial fibrillation (AF) occurs frequently after mitral valve (MV) surgery. This study aims to evaluate the efficacy and long-term clinical outcomes after the first AF ablation in patients with prior MV surgery.MethodsSixty consecutive patients with a history of MV surgery without MAZE referred...
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-12-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.928974/full |
| _version_ | 1811195273922215936 |
|---|---|
| author | Alexandre Almorad Alexandre Almorad Louisa O'Neill Jean-Yves Wielandts Kris Gillis Benjamin De Becker Yosuke Nakatani Carlo De Asmundis Saverio Iacopino Thomas Pambrun La Meir Marc Pierre Jaïs Michel Haïssaguerre Mattias Duytschaever Jean-Baptista Chierchia Nicolas Derval Sébastien Knecht |
| author_facet | Alexandre Almorad Alexandre Almorad Louisa O'Neill Jean-Yves Wielandts Kris Gillis Benjamin De Becker Yosuke Nakatani Carlo De Asmundis Saverio Iacopino Thomas Pambrun La Meir Marc Pierre Jaïs Michel Haïssaguerre Mattias Duytschaever Jean-Baptista Chierchia Nicolas Derval Sébastien Knecht |
| author_sort | Alexandre Almorad |
| collection | DOAJ |
| description | AimsAtrial fibrillation (AF) occurs frequently after mitral valve (MV) surgery. This study aims to evaluate the efficacy and long-term clinical outcomes after the first AF ablation in patients with prior MV surgery.MethodsSixty consecutive patients with a history of MV surgery without MAZE referred to three European centers for a first AF ablation between 2007 and 2017 (group 1) were retrospectively enrolled. They were matched (propensity score match) with 60 patients referred for AF ablation without prior MV surgery (group 2).ResultsAfter the index ablation, 19 patients (31.7%) from group 1 and 24 (40%) from group 2 had no recurrence of atrial arrhythmias (ATa) (p = 0.3). After 62 (48–84) months of follow-up and 2 (2–2) procedures, 90.0% of group 1 and 95.0% of group 2 patients were in sinus rhythm (p = 0.49). In group 1, 19 (31.7%) patients had mitral stenosis, and 41 (68.3%) had mitral regurgitation. Twenty-seven (45.0%) patients underwent mechanical valve replacement and 33 (55.0%) MV annuloplasty. At the final follow-up, 28 (46.7%) and 33 (55.0%) patients were off antiarrhythmic drugs (p = 0.46). ATa recurrence was seen more commonly in patients with prior MV surgery (54 vs. 22%, respectively, p < 0.05). No major complication occurred.ConclusionLong-term freedom of atrial arrhythmias after atrial fibrillation catheter ablation is achievable and safe in patients with a history of mitral valve surgery. In AF patients without a history of mitral valve surgery, repeated procedures are needed to maintain sinus rhythm. |
| first_indexed | 2024-04-12T00:40:43Z |
| format | Article |
| id | doaj.art-9b786c6a9234451ba9dc6f83c87a254f |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-12T00:40:43Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-9b786c6a9234451ba9dc6f83c87a254f2022-12-22T03:55:01ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-12-01910.3389/fcvm.2022.928974928974Long-term clinical outcome of atrial fibrillation ablation in patients with history of mitral valve surgeryAlexandre Almorad0Alexandre Almorad1Louisa O'Neill2Jean-Yves Wielandts3Kris Gillis4Benjamin De Becker5Yosuke Nakatani6Carlo De Asmundis7Saverio Iacopino8Thomas Pambrun9La Meir Marc10Pierre Jaïs11Michel Haïssaguerre12Mattias Duytschaever13Jean-Baptista Chierchia14Nicolas Derval15Sébastien Knecht16Department of Cardiology, AZ Sint Jan Hospital Bruges, Bruges, BelgiumHeart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, Brussels, BelgiumDepartment of Cardiology, AZ Sint Jan Hospital Bruges, Bruges, BelgiumDepartment of Cardiology, AZ Sint Jan Hospital Bruges, Bruges, BelgiumDepartment of Cardiology, AZ Sint Jan Hospital Bruges, Bruges, BelgiumDepartment of Cardiology, AZ Sint Jan Hospital Bruges, Bruges, BelgiumDepartment of Cardiac Pacing and Electrophysiology, Hospital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, Pessac, FranceHeart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, Brussels, BelgiumHeart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, Brussels, BelgiumDepartment of Cardiac Pacing and Electrophysiology, Hospital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, Pessac, FranceHeart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, Brussels, BelgiumDepartment of Cardiac Pacing and Electrophysiology, Hospital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, Pessac, FranceDepartment of Cardiac Pacing and Electrophysiology, Hospital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, Pessac, FranceDepartment of Cardiology, AZ Sint Jan Hospital Bruges, Bruges, BelgiumHeart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, Brussels, BelgiumDepartment of Cardiac Pacing and Electrophysiology, Hospital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, Pessac, FranceDepartment of Cardiology, AZ Sint Jan Hospital Bruges, Bruges, BelgiumAimsAtrial fibrillation (AF) occurs frequently after mitral valve (MV) surgery. This study aims to evaluate the efficacy and long-term clinical outcomes after the first AF ablation in patients with prior MV surgery.MethodsSixty consecutive patients with a history of MV surgery without MAZE referred to three European centers for a first AF ablation between 2007 and 2017 (group 1) were retrospectively enrolled. They were matched (propensity score match) with 60 patients referred for AF ablation without prior MV surgery (group 2).ResultsAfter the index ablation, 19 patients (31.7%) from group 1 and 24 (40%) from group 2 had no recurrence of atrial arrhythmias (ATa) (p = 0.3). After 62 (48–84) months of follow-up and 2 (2–2) procedures, 90.0% of group 1 and 95.0% of group 2 patients were in sinus rhythm (p = 0.49). In group 1, 19 (31.7%) patients had mitral stenosis, and 41 (68.3%) had mitral regurgitation. Twenty-seven (45.0%) patients underwent mechanical valve replacement and 33 (55.0%) MV annuloplasty. At the final follow-up, 28 (46.7%) and 33 (55.0%) patients were off antiarrhythmic drugs (p = 0.46). ATa recurrence was seen more commonly in patients with prior MV surgery (54 vs. 22%, respectively, p < 0.05). No major complication occurred.ConclusionLong-term freedom of atrial arrhythmias after atrial fibrillation catheter ablation is achievable and safe in patients with a history of mitral valve surgery. In AF patients without a history of mitral valve surgery, repeated procedures are needed to maintain sinus rhythm.https://www.frontiersin.org/articles/10.3389/fcvm.2022.928974/fullatrial fibrillationmitral valve surgeryablationatrial tachyarrhythmiasantiarrhythmic drugs |
| spellingShingle | Alexandre Almorad Alexandre Almorad Louisa O'Neill Jean-Yves Wielandts Kris Gillis Benjamin De Becker Yosuke Nakatani Carlo De Asmundis Saverio Iacopino Thomas Pambrun La Meir Marc Pierre Jaïs Michel Haïssaguerre Mattias Duytschaever Jean-Baptista Chierchia Nicolas Derval Sébastien Knecht Long-term clinical outcome of atrial fibrillation ablation in patients with history of mitral valve surgery Frontiers in Cardiovascular Medicine atrial fibrillation mitral valve surgery ablation atrial tachyarrhythmias antiarrhythmic drugs |
| title | Long-term clinical outcome of atrial fibrillation ablation in patients with history of mitral valve surgery |
| title_full | Long-term clinical outcome of atrial fibrillation ablation in patients with history of mitral valve surgery |
| title_fullStr | Long-term clinical outcome of atrial fibrillation ablation in patients with history of mitral valve surgery |
| title_full_unstemmed | Long-term clinical outcome of atrial fibrillation ablation in patients with history of mitral valve surgery |
| title_short | Long-term clinical outcome of atrial fibrillation ablation in patients with history of mitral valve surgery |
| title_sort | long term clinical outcome of atrial fibrillation ablation in patients with history of mitral valve surgery |
| topic | atrial fibrillation mitral valve surgery ablation atrial tachyarrhythmias antiarrhythmic drugs |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.928974/full |
| work_keys_str_mv | AT alexandrealmorad longtermclinicaloutcomeofatrialfibrillationablationinpatientswithhistoryofmitralvalvesurgery AT alexandrealmorad longtermclinicaloutcomeofatrialfibrillationablationinpatientswithhistoryofmitralvalvesurgery AT louisaoneill longtermclinicaloutcomeofatrialfibrillationablationinpatientswithhistoryofmitralvalvesurgery AT jeanyveswielandts longtermclinicaloutcomeofatrialfibrillationablationinpatientswithhistoryofmitralvalvesurgery AT krisgillis longtermclinicaloutcomeofatrialfibrillationablationinpatientswithhistoryofmitralvalvesurgery AT benjamindebecker longtermclinicaloutcomeofatrialfibrillationablationinpatientswithhistoryofmitralvalvesurgery AT yosukenakatani longtermclinicaloutcomeofatrialfibrillationablationinpatientswithhistoryofmitralvalvesurgery AT carlodeasmundis longtermclinicaloutcomeofatrialfibrillationablationinpatientswithhistoryofmitralvalvesurgery AT saverioiacopino longtermclinicaloutcomeofatrialfibrillationablationinpatientswithhistoryofmitralvalvesurgery AT thomaspambrun longtermclinicaloutcomeofatrialfibrillationablationinpatientswithhistoryofmitralvalvesurgery AT lameirmarc longtermclinicaloutcomeofatrialfibrillationablationinpatientswithhistoryofmitralvalvesurgery AT pierrejais longtermclinicaloutcomeofatrialfibrillationablationinpatientswithhistoryofmitralvalvesurgery AT michelhaissaguerre longtermclinicaloutcomeofatrialfibrillationablationinpatientswithhistoryofmitralvalvesurgery AT mattiasduytschaever longtermclinicaloutcomeofatrialfibrillationablationinpatientswithhistoryofmitralvalvesurgery AT jeanbaptistachierchia longtermclinicaloutcomeofatrialfibrillationablationinpatientswithhistoryofmitralvalvesurgery AT nicolasderval longtermclinicaloutcomeofatrialfibrillationablationinpatientswithhistoryofmitralvalvesurgery AT sebastienknecht longtermclinicaloutcomeofatrialfibrillationablationinpatientswithhistoryofmitralvalvesurgery |