Efficacy of Intraoperative Radio frequency Ablation in Patients Undergoing Mitral Valve Replacement for Rheumatic Heart Disease Complicated by Chronic Atrial Fibrillation.

Background Atrial fibrillation (AF) is a common arrhythmia, especially prevalent among patients with rheumatic heart disease (RHD). The presence of AF in these patients significantly exacerbates the risk of thromboembolic events and heart failure. This study evaluates the efficacy of intraoperative Radio frequency ablation (RFA) performed concomitantly with mitral valve replacement (MVR) in patients with RHD complicated by chronic AF. Results Twenty patients with permanent AF and mitral valve disease underwent MVR with concomitant RF ablation. Outcomes measured included conversion to sinus rhythm, left ventricular ejection fraction (LVEF), left atrial (LA) size, antiarrhythmic burden, and quality of life. At one year post-operation, 95% of patients had converted to sinus rhythm. Mean LVEF improved from 46.00% preoperatively to 52.25% postoperatively. LA size decreased significantly from a mean of 55.25 mm to 45.75 mm. Antiarrhythmic burden decreased by 50% in 85% of patients. No mortality was observed. Conclusion Intraoperative RF ablation concomitant with MVR is a safe and effective procedure for patients with RHD and chronic AF, resulting in high rates of sinus rhythm conversion, improved cardiac function, and reduced antiarrhythmic burden.