The role of corticosteroid therapy following surgery for atrial fibrillation.
BACKGROUND
The objective of our study was to evaluate the usefulness of steroids therapy for patients who underwent surgery for chronic atrial fibrillation, with histologic findings of myocarditis.


METHODS
Between April 1991 and July 2002, 144 patients underwent surgery for chronic atrial fibrillation at the time of other cardiac operations, at the Department of Cardiovascular surgery of the University of Bologna. Fragments of left and right appendages were provided for each patient for histologic study: In three patients myocarditis was identified and they were treated with steroid therapy until the postoperative day 60. We report here the case of our first successfully treated patient with a longer follow-up time.


RESULTS
The patient was discharged on postoperative day 30, in sinus rhythm. At follow-up, 9 months after surgery, she was doing well and working full time; the ECG showed sinus rhythm, and echocardiography demonstrated biatrial contraction.


CONCLUSIONS
According to our experience, the histologic diagnosis of myocarditis allowed us to modify the therapeutic approach in patients who underwent surgery for atrial fibrillation, in which the addition of steroids to antiarrhythmic therapy, in the early postoperative period, is able to induce the recovery of sinus rhythm.
Chiappini
Bruno
B
Department of Cardiovascular Surgery, Policlinico S.Orsola-Malpighi, University of Bologna, Bologna. bruno_chiappini@hotmail.com
Leone
Ornella
O
Bracchetti
Giovanni
G
Marinelli
Giuseppe
G
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation; D004554:Electric Countershock; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000503:physiopathology / Q000601:surgery; D009200:Myocardial Contraction / Q000502:physiology; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology; D012008:Recurrence; D012213:Rheumatic Fever / Q000503:physiopathology / Q000601:surgery; D013318:Stroke Volume / Q000502:physiology
D000305:Adrenal Cortex Hormones; D000889:Anti-Arrhythmia Agents; D000638:Amiodarone; D008775:Methylprednisolone