Impact of Atrial Fibrillation on Clinical Status, Atrial Size and Hemodynamics in Patients after Mitral Valve Replacement
Mordehay Vaturi MD, Alex Sagie MD, Yaron Shapira MD, Anat Feldman MD, Noam Fink MD, Boris Strasberg MD, Yehuda Adler MD

The study aim was to investigate whether atrial fibrillation (AF) after mitral valve replacement (MVR) impacts on clinical and echocardiographic parameters. Eighty-six patients were allocated to two groups (AF and sinus rhythm) and evaluated clinically and by transthoracic color-Doppler echocardiography. Patients with AF postoperatively had a worse NYHA class than those in sinus rhythm, despite preserved function of the prosthetic valve and similar left ventricular fractional shortening. AF patients also had increased transmitral gradients and larger left and right atrial sizes. On multivariate analysis, AF alone was the predictor of postoperative NYHA class. Duration of AF had a significant influence on atrial size. Compared with sinus rhythm, AF after MVR is associated with a worse NYHA class, increased transmitral gradients, and larger areas of both atria.