Percutaneous Transvenous Mitral Commissurotomy and Radiofrequency Catheter Ablation in Patients With Mitral Stenosis

Background The purpose of this study was to evaluate the short- and long-term results of radiofrequency catheter ablation (RFCA) for the treatment of atrial fibrillation (AF) in patients with mitral stenosis (MS) following percutaneous transvenous mitral commissurotomy (PTMC). Methods and Results Four patients (2 males, age 59±6 years) underwent simultaneous PTMC and pulmonary vein (PV) ablation. All patient had AF and MS (2 had persistent AF >1 month, 2 had paroxysmal AF), and the mean duration of AF was 3.4±3.3 years. The mean left atrial dimension was 47±7 mm and the mean ejection fraction was 58±4%. After PTMC, RFCA was performed in all patients (3 underwent PV isolation and 1 had PV focal ablation). The mitral valve area increased from 1.11 ±0.19 to 1.90±0.20 cm2 (p<0.01). The frequency of AF episodes was dramatically reduced in the 2 patients with paroxysmal AF, and the 1 with persistent AF maintained sinus rhythm, but 1 patient with persistent AF developed recurrent AF. No complications or cardiac events occurred in any of the patients. Conclusion The combination of RFCA and PTMC was safe and feasible, and may be useful in patients with MS and AF. (Circ J 2005; 69: 1074 - 1078)