| Introduction: Atrial fibrillation (AF) is the most common arrhythmia in patients with mitral
stenosis (MS) and it may increase complications and decreases success rates of percutaneous
balloon mitral valvotomy (PBMV). This study aimed to investigate the short and long term results
of PBMV in patients with AF compared to sinus rhythm (SR).
Methods: In this cross sectional study, 1000 patients with MS who had undergone PBMV between
1999 and 2013 were enrolled including 585 and 415 patients with AF and SR respectively. Patients
were followed for a mean of 7.27 ± 3.16 years. Clinical, echocardiographic and hemodynamic data
were collected. Procedure success, in-hospital and long-term outcome were evaluated.
Results: Patients with AF were older and had greater symptoms, mitral regurgitation, mitral
echocardiographic score, and mitral pressure gradient before PBMV. PBMV success rate were
significantly lower in AF group (P < 0.001). In-hospital complications, including severe mitral
regurgitation, emergency mitral valve surgery, peripheral embolism and long-term complications,
including mortality, re-valvotomy, mitral replacement surgery and peripheral embolism/stroke
were significantly higher in patients with AF.
Conclusion: AF leads to worse in-hospital and long-term outcome and lower PBMV success
rate. Repeated assessment and early decision to PBMV in patients with MS to reduce AF and AF
related complication seems necessary. |