patients with mitral stenosis (MS), the most common complication is AF. Our study aimed at evaluating the effect of AF
cardioversion after Percutaneous Mitral Balloon Valvuloplasty (PMBV) on
echocardiographic atrial functions.
study included 34 patients with MS and AF, presenting to Ain-shams University
hospitals, who underwent successful PMBV then randomized into 2 different
groups according to AF management strategy. Group-I patients (n=16)
received DC cardioversion after amiodarone infusion (within 24 hours post-PMBV)
in addition to anticoagulation. Group-II patients (n= 18) were kept on
the rate control strategy for AF and anticoagulation. Atrial functions were
evaluated by echocardiography before and 48-72 hours after PMBV.
Both groups were
homogenous regarding demographic, clinical and echocardiographic data before
PMBV. Both groups showed significant
improvement in MVA (Group-I: 0.953 ± 0.144cm2 to 2.26 ±
0.463cm2, p=0.000, Group-II: 0.942 ± 0.171cm2 to 1.95 ± 0.40cm2 , p=0.0000) , left atrial emptying fraction
(Group-I: 16.11 ± 6.93% to 26.16 ± 5.51%, p=0.000 , Group-II: 18.49 ± 5.47% to 26.12 ± 7.68%, p=0.002), left atrial function index (Group-I: 4.48 ± 2.32 to 6.84 ± 3.35, p=0.001 , Group-II: 3.34 ±
1.42 to 7.80 ± 4.17, p=0.006) as well as estimated systolic pulmonary
artery pressure (Group-I: 49.06 ± 13.86 to 38.25 ± 7.29, p=0.01
, Group-II: 53.44 ± 14.52 to 39.88 ± 10.67, p=0.003). For
group-I patients, reduction in left atrial end-diastolic volume was significant
(120.84 ± 32.82 mL to 95.31 ± 19.27mL, p=0.012) and
TAPSE showed significant improvement (17.57± 4.96 to 21.08 ± 2.52, p=0.018).
When percentage improvement in variables was compared between both groups, none
of the indices used to evaluate atrial functions showed any significant
difference between both groups.
functions improve post-PMBV. No additional improvement in atrial functions
occurs after cardioversion in patients who have already undergone PMBV, at
least within 72-hours.
Credits: Sameh Samir; Amal Ayoub; Said Khaled; Hossam Zaki