The Analysis Of Affecting Factors On Natural Conversion Of Atrial Fibrillation For Rheumatic Mitral Stenosis In Patients After Mitral Valvuloplasty

Objective:To evaluate the effective factors of natural conversion of atrial fibrillation(AF)by percutaneous balloon mitral valvuloplasty(PBMV)or mitral valve replacement in patients with rheumatic mitral stenosis.Methods:From January 1994 to June 2006,65.consecutive patients with rheumatic mitral stenosis and atrial fibrillation who underwent PBMV and 337 patients who underwent mitral valve replacement were analysed retrospectively.In this study,clinical histories,echocardiograms,clinical datas, and follow-up data were viewed to evaluate the rate and predict the natural restoration of sinus rhythm.Results:15 patients(23%)of 65 patients regained sinus rhythm after PBMV within two weeks,during the follow-up period(3-6 months)only 10 patients(15%) maintained sinus rhythm;98 patients(29%)of 337 patients regained sinus rhythm after mitral valve replacement within two weeks,during the follow-up period(3-6 months) only 47 patients(14%)maintained sinus rhythm.Age(P＜0.01,OR 1.24),duration of AF (P＜0.01,OR 1.18),left atrail size before PBMV or mitral valve replacement(P＜0.01,OR 1.28)and left atrail size after PBMV or mitral valve replacement(P＜0.01,OR1.72)were independent dangerous factors of affecting AF conversion.Conclusion:AF can restore sinus rhythm in some patients with rheumatic mitral stenosis after PBMV or mitral valve replacement.Age,duration of AF,and left atrail size are dependent dangerous factors to influence natural convertion of AF.