Prognostic Predictors of Sinus Rhythm Control by Amiodarone and Electrical Cardioversion in Patients Undergoing Percutaneous Transluminal Mitral Valvuloplasty for Rheumatic Atrial Fibrillation

• Guo Gary Bih-Fang

  Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine

• Hang Chi-Ling

  Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine

• Chang Hsueh-Wen

  Department of Biological Sciences, National Sun Yat-Sen University

• Wu Chiung-Jen

  Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine

• Fang Chih-Yuan

  Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine

• Chen Chien-Jen

  Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine

抄録

Background Conversion to sinus rhythm (SR) is rarely attempted in patients with rheumatic atrial fibrillation (AF) because the length of AF duration and the dilation of left atrium (LA) make maintenance of SR difficult. In this study, predictors of the successful maintenance of SR with amiodarone and electrical cardioversion in rheumatic AF patients receiving percutaneous transluminal mitral valvuloplasty (PTMV) were identified Methods and Results This study included 23 consecutive patients undergoing PTMV for rheumatic AF (6 men, 53±11 years; AF duration 25 ±24 months; LA diameter 44±6 mm; mitral valve area (MV) 1.1±0.2 cm²). Electrical cardioversion was required for the successful conversion to SR in all patients regardless of whether they had received amiodarone (400 mg/day) 2 months before PTMV (n=8) or 2 months after (n=15). After cardioversion, all patients received amiodarone 200 mg/day. With a follow-up period of 35±8 months, 14 patients (61%) remained in SR. A greater reduction in LA size (-4±3 mm vs 1±1 mm; p=0.004) and an greater increase in MV area (0.8±0.4 cm² vs 0.5±0.2 cm²; p=0.01) by PTMV, not AF duration, were found to be the independent predictors for patients with successful maintenance of SR as compared with patients with recurrence of AF. Conclusion In rheumatic AF patients receiving PTMV, the successful maintenance of SR with amiodarone and electrical cardioversion can be predicted by the degree to which LA size is reduced and MV area is increased. (Circ J 2007; 71: 1115 - 1119)<br>

収録刊行物

• Circulation Journal

  Circulation Journal 71 (7), 1115-1119, 2007

  一般社団法人 日本循環器学会

キーワード

• Atrial fibrillation
• Cardioversion
• Mitral stenosis
• Percutaneous transluminal mitral valvuloplasty

詳細情報

• CRID: 1390001205105191936
• NII論文ID: 110006318414
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.71.1115
• ISSN: 13474820
• ISSN: 13469843
• Web Site: http://www.jstage.jst.go.jp/article/circj/71/7/71_7_1115/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2008001644
• 本文言語コード: en
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