SIMPLE LEFT ATRIAL PROCEDURE FOR CHRONIC ATRIAL-FIBRILLATION ASSOCIATED WITH MITRAL-VALVE DISEASE

Background. A computerized 48-channel mapping system was used to inves tigate the characteristics of an atrial epicardial electrogram during chronic atrial fibrillation (AF) in patients with solitary mitral valv e disease. We have devised a simple left atrial procedure to eliminate the chronic AF during a mitral valve operation. Methods. Using this m apping system, we performed intraoperative atrial mapping in II patien ts with chronic AF associated with mitral valve disease. The AF durati on ranged from 0.4 to 15 years (mean, 8.0 +/- 4.5 years). A simple sur gical ablation of the AF on the left atrium only was performed during the mitral valve operation. Results. The mean AF cycle length of the a tria ranged from 129 to 169 milliseconds in the right atrium and from 114 to 139 milliseconds in the left atrium, The mean AF cycle length o f the left atrium was shorter than that of the right atrium. Regular a nd repetitive activation was found in the left atria of 7 of 11 patien ts. The AF disappeared in all patients immediately after the operation , and 10 of these patients continued to have a sinus rhythm postoperat ively (AF-free rate, 91%). Conclusions. Computerized intraoperative ma pping revealed a shorter mean AF cycle length in the left atrium. A si mple left atrial procedure was effective in eliminating chronic AF ass ociated with solitary mitral valve disease.