Clinical analysis of results of a simple left atrial procedure for chronic atrial fibrillation

Background. We have performed a simple left atrial procedure for eliminating chronic atrial fibrillation (AF) associated with mitral valve disease. This article analyzes the midterm results of this procedure. Methods. Thirty-two patients were enrolled in this study concomitant with mitral valve operations. Patients were divided into two groups (AF- and AF+). We examined the efficacy of this operation and atrial function for more than 12 months of follow-up. Results. In a total of 98.5 patient years of follow-up, AF was absent 3 years after operation in 74%. Of preoperative and intraoperative variables, only long duration of AF was a predisposing factor for recurrence of AF (p < 0.05). In the AF- group, 5 patients (21%) showed atrial tachycardia or flutter and 5 (21%) needed postoperative pacemaker implantation. An A wave was detected in 60% across the mitral valve and 100% across the tricuspid. Conclusions. A simple left atrial procedure is effective for chronic AF with mitral valve disease and restores atrial transport function during midterm follow-up. However, other atrial arrhythmias occur in some patients postoperatively. (C) 2001 by The Society of Thoracic Surgeons.