title: Sinus Rhythm in Rheumatic Mitral Stenosis after Balloon Mitral Valvotomy: Is it Feasible?
abstract: BACKGROUND
  Atrial Fibrillation (AF) is largely present in patients with rheumatic valvular disease, leading to hospitalizations.
  
  
  OBJECTIVE
  We aimed to study the restoration and maintenance of Sinus Rhythm (SR) in rheumatic patients with Mitral Stenosis (MS) and AF after Balloon Mitral Valvotomy (BMV) and evaluated the factors which affect the maintenance of SR.
  
  
  METHODS
  A total of 50 patients who underwent BMV at U. N. Mehta Institute of Cardiology and Research Centre from 2010 November to 2013 January were included in the study. Subsequently, all patients were treated with amiodarone and electrical cardioversion was applied in patients in whom it was necessary. The patients were followed for six months for conversion and maintenance of SR.
  
  
  RESULTS
  Total 34 (68%) patients reverted to SR. Twelve patients reverted to SR with amiodarone and 22 patients with electrical cardioversion and amiodarone. Out of the total, 29 patients and 26 patients remained in SR at the end of follow up at 3 months and 6 months respectively.
  
  
  CONCLUSIONS
  Smaller Left Atrial (LA) size and greater Mitral Valve Area (MVA) are the chief predictors of restoration and maintenance of SR. Combining BMV with an aggressive anti-arrhythmic strategy offers the best prospect of rhythm control.
authors.affiliation: Assistant Professor, Department of Cardiology, Kasturba Medical College, Manipal University , Manipal, Karnataka, India .
authors.forename: Ashwal A
authors.initials: AA
authors.lastname: Jayaram
authors.affiliation: Associate Professor, Department of Cardiology, U.N.Mehta Institute of Cardiology and Research Centre , Gujarat, India .
authors.forename: Anand N
authors.initials: AN
authors.lastname: Shukla
authors.affiliation: Assistant Professor, Department of Cardiology, U.N.Mehta Institute of Cardiology and Research Centre , Gujarat, India .
authors.forename: Saurin
authors.initials: S
authors.lastname: Shah
authors.affiliation: Assistant Professor, Department of CVT, School of Allied Health Sciences, Manipal University , Karnataka, India .
authors.forename: Vidya
authors.initials: V
authors.lastname: Nayak
authors.affiliation: Assistant Professor, Department of CVT, School of Allied Health Sciences, Manipal University , Karnataka, India .
authors.forename: Sridevi
authors.initials: S
authors.lastname: Prabhu
authors.affiliation: Assistant Professor, Department of CVT, School of Allied Health Sciences, Manipal University , Karnataka, India .
authors.forename: Umesh
authors.initials: U
authors.lastname: Pai
keywords: Amiodarone; Atrial fibrillation; Rheumatic heart disease