Predictive factors for persistence of atrial fibrillation after mitral valve operation

Background. The majority of patients operated on for mitral valve disease w ith chronic atrial fibrillation (AF) do not recover sinus rhythm with conve ntional postoperative treatment. The maze procedure may be used in these ci rcumstances. To define the precise indications for the maze procedure, it w ould be necessary to identify those patients based on preoperative factors. Methods. A retrospective study was undertaken on 100 consecutive patients o perated on for mitral valve disease in chronic AF. The return to sinus rhyt hm was analyzed with relation to age, gender, AF duration, left atrial size , left ventricular ejection fraction, lesion type, valve procedure, associa ted procedures, and reoperation. Results. At late follow-up (more than 1 year) 26 (26%) patients presented s inus rhythm and 74 (74%) remained in AF. Statistical single parametric anal ysis demonstrated that mitral stenosis was a risk: factor for maintaining A F, whereas regurgitation was more associated to sinus rhythm recovery. Ther e was no relation with the other parameters with return to sinus rhythm. It should be noted, however, that 96% of this series had AF for more than 6 m onths preoperatively. Conclusions. The majority of patients with mitral valve disease remain in A F and this may justify the association of maze procedure. Pure regurgitatio n may be a single predictor for return to sinus rhythm after mitral valve o peration in chronic AF. (Ann Thorac Surg 1999;67:614-7) (C) 1999 by The Soc iety of Thoracic Surgeons.