Conversion to sinus rhythm by ablation improves quality of life in patients submitted to mitral valve surgery.
BACKGROUND
Atrial fibrillation can be successfully treated with surgical ablation, but the effect of restoring sinus rhythm on the quality of life has yet to be established. We evaluate the effects of left atrial ablation combined with mitral valve surgery on health-related quality of life in patients with permanent atrial fibrillation.


METHODS
Ninety-one consecutive patients with permanent atrial fibrillation underwent mitral valve surgery at our division. The last 53 also received left atrial ablation by means of monopolar radiofrequency and excision of the left appendage. The patients were divided into two groups according to the median total score obtained at the Short Form 36 Health Survey used to evaluate their quality of life (ie, the good quality of life group [n = 54] and the poor quality of life group [n = 37]).


RESULTS
Preoperative and intraoperative data of the two groups were similar. In-hospital mortality and morbidity were similar in both groups. Sinus rhythm was obtained in 68% of patients (36 of 53) treated with left atrial ablation and it occurred spontaneously in 10% of patients (4 of 38) treated for the mitral pathology only. At follow-up, there was no difference between the groups in ejection fraction, left atrial diameter, mitral dysfunction, tricuspidal regurgitation, and New York Heart Association functional class. Using stepwise logistic regression, only the presence of sinus rhythm was associated with better quality of life.


CONCLUSIONS
In patients submitted to mitral surgery, conversion to sinus rhythm by left atrial ablation can significantly improve the health-related quality of life.
Division of Cardiac Surgery, University of Rome, Tor Vergata, Rome, Italy. stefanoforlani@gmail.com
Stefano
S
Forlani
Ruggero
R
De Paulis
Lorenzo
L
Guerrieri Wolf
Renata
R
Greco
Patrizio
P
Polisca
Marco
M
Moscarelli
Luigi
L
Chiariello
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000628:therapy; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation; D001026:Coronary Artery Bypass; D004452:Echocardiography; D005260:Female; D006306:Health Surveys; D006339:Heart Rate; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D010146:Pain; D011788:Quality of Life; D016896:Treatment Outcome; D016277:Ventricular Function, Left