Maintenance of sinus rhythm and treatment of atrial fibrillation in mitral stenosis

Abstract

Abstract. Rheumatic fever is the most common cause of mitral stenosis. The most common complication of mitral stenosis is atrial fibrillation (AF). AF precipitates symptoms, greatly increases the risk of systemic embolisation, and reduces cardiac output and exercise capacity. Systemic embolization most often occurs in patients with both AF and mitral stenosis. Maintenance of the sinus rhythm in patients with mitral stenosis is very important because of reduce the risk of cerebral embolism, conservation of cardiac output and exercise capacity, and reduction of symptoms.

Key words: mitral stenosis, atrial fibrillation, cerebral embolism

Keywords

• mitral stenosis, atrial fibrillation, cerebral embolism

References

1. 1. Sagie A, Freitas N, Padial LR, et al. Doppler echocardiographic assessment of long-term progression of mitral stenosis in 103 patients: Valve area and right heart disease. J Am Coll Cardiol 1996; 28: 472-479.
2. 2. Otto CM, Bonow RO. Valvular heart disease. In: Braunwald E. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 8th ed. Philadelphia, Saunders 2008: 1646-1656.
3. 3. Vora A, Karnad D, Goyal V, et al. Control of rate versus rhythm in rheumatic atrial fibrillation: a randomized study. Indian Heart J 2004; 56: 110- 116.
4. 4. Klocke FJ, Baird MG, Lorell BH, et al. ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionuclide Imaging). Circulation 2003; 108: 1404-1418.
5. 5. Vijaykumar M, Narula J, Reddy KS, Kaplan EL. Incidence of rheumatic fever and prevalence of rheumatic heart disease in India. Int J Cardiol 1994; 43: 221-228.
6. 6. Wood P. An appreciation of mitral stenosis. I. Clinical features. Br Med J 1954; 1: 1051-1063.
7. 7. Rowe JC, Bland EF, Sprague HB, White PD. The course of mitral stenosis without surgery: ten- and twenty-year perspectives. Ann Intern Med 1960; 52: 741–749.
8. 8. Olesen KH. The natural history of 271 patients with mitral Stenosis under medical treatment. Br Heart J 1962; 24: 349-357.

9. 9. Moore AG. Rheumatic Heart Disease. In: Murphy JG, Lloyd MA. Mayo Clinic Cardiology, third edition. Rochester, Mayo Clinic Scientific Pres 2007: 549-554.
10. 10. Filgner CL, Reichenbach DD, Otto CM. Pathology and etiology of valvular heart disease. In: Otto CM, ed. Valvular Heart Disease, 2nd ed. Philadelphia: Saunders 2004: 30-33.
11. 11. Roberts WC, Perloff JK. Mitral valvular disease: a clinicopathologic survey of the conditions causing the mitral valve to function abnormally. Ann Intern Med 1972; 77: 939-975.
12. 12. Gorlin R, Gorlin SG. Hydraulic formula for calculation of the area of the stenotic mitral valve, other cardiac valves, and central circulatory shunts. Am Heart J 1951; 41: 1-29.
13. 13. Grossman W. Profiles in valvular heart disease. In: Baim DS, Grossman W, ed. Cardiac Catheterization, Angiography and Interventions, 6th ed. Baltimore: Lippincott Williams & Wilkins 2000; 759-783.
14. 14. Doukas G, Samani NJ, Alexiou C, et al. Left atrial radiofrequency ablation during mitral valve surgery for continuous atrial fibrillation: a randomized controlled trial. JAMA 2005; 294: 2357-2359.
15. 15. Bonow RO, Carabello BA, Chatterjee K, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients with Valvular Heart Disease): Developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation 2006; 114: 84.
16. 16. Hugenholtz PG, Ryan TJ, Stein SW, Belmann WH. The spectrum of pure mitral stenosis: hemodynamic studies in relation to clinical disability. Am J Cardiol 1962; 10: 773-784.
17. 17. Bonow RO, Carabello BA, Chatterjee K, et al. 2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation 2008; 118: 523-661.
18. 18. Krasuski RA, Assar MD, Wang A, et al. Usefulness of percutaneous balloon mitral commissurotomy in preventing the development of atrial fibrillation in patients with mitral stenosis. Am J Cardiol 2004; 93: 936-939.
19. 19. Coulshed N, Epstein EJ, McKendrick CS, Galloway RW, Walker E. Systemic embolism in mitral valve disease. Br Heart J 1970; 32: 26-34.
20. 20. Erbay AR, Turhan H, Yasar AS, et al. Effects of long-term beta-blocker therapy on P-wave duration and dispersion in patients with rheumatic mitral stenosis. International Journal of Cardiology 2005; 102: 33-37.
21. 21. Chandrashekhar Y, Westaby S, Narula J. Mitral stenosis. Lancet 2009; 374: 1271-1283.
22. 22. Chiang CW, Lo SK, Cheng NJ, Lin PJ, Chang CH. Predictors of systemic embolism in patients with mitral stenosis. A prospective study. Ann Intern Med 1988; 128: 885-889.
23. 23. Gorlin R. The mechanism of the signs and symptoms of mitral valve disease. Br Heart J 1954; 16: 375-380.
24. 24. Beiser GD, Epstein SE, Stampfer M, Robinson B, Braunwald E. Studies on digitalis, XVII: effects of ouabain on the hemodynamic response to exercise in patients with mitral stenosis in normal sinus rhythm. N Engl J Med 1968; 278: 131–137.
25. 25. Abernathy WS, Willis PW 3rd. Thromboembolic complications of rheumatic heart disease. Cardiovasc Clin 1973; 5: 131-175.
26. 26. Adams GF, Merrett JD, Hutchinson WM, Pollock AM. Cerebral embolism and mitral stenosis: survival with and without anticoagulants. J Neurol Neurosurg Psych 1974; 37: 378-383.
27. 27. Otto CM: Surgical and percutaneous intervention for mitral stenosis. In: Otto CM, ed. Valvular Heart Disease, 2nd ed. Philadelphia: Saunders 2004: 272- 276.
28. 28. Abreu Filho CA, Lisboa LA, Dallan LA, et al. Effectiveness of the maze procedure using cooledtip radiofrequency ablation in patients with permanent atrial fibrillation and rheumatic mitral valve disease. Circulation 2005; 112: 120-125.
29. 29. Bando K, Kasegawa H, Okada Y, et al. Impact of preoperative and postoperative atrial fibrillation on outcome after mitral valvuloplasty for nonischemic mitral regurgitation. J Thorac Cardiovasc Surg 2005; 129: 1032-1040.
30. 30. Laupacis A, Albers G, Dunn M, Feinberg W. Antithrombotic therapy in atrial fibrillation. Chest 1992; 102: 426-433.