Aims: Little information is available about short-term and none about long-term follow-up of cardiac rhythm after percutaneous mitral balloon valvotomy (PTMV).
Methods and results: We studied the long-term course of the supraventricular rhythm in 137 consecutive patients with severe mitral stenosis, who underwent PTMV. The rhythm before PTMV was sinus rhythm (SR) in 55% and chronic AF in 45% of patients. The mean follow-up time was 3.7+/-2.5 years (n=126). In patients with SR before PTMV, SR persisted in 91% of patients at the end of follow-up. In patients with chronic AF before PTMV, 84% of these patients were still in chronic AF at the end of follow-up, spontaneous conversion to SR did not occur. In 12 of 14 patients (85%), selected for cardioversion, SR was achieved, by DC cardioversion (n=11) or by drugs alone (n=1). After 2 years this outcome persisted, but after 4 years only 38% remained in SR.
Conclusion: Pre-procedural SR will persist following PTMV. However in patients with chronic AF PTMV is not associated with reversion to SR, suggesting that measures should be undertaken to restore sinus rhythm.
Copyright 2003 The European Society of Cardiology.