Echocardiographic Prediction of Symptomatic Atrial Fibrillation In Patients with Rheumatic Mitral Stenosis and Normal Sinus Rhythm

Objectives: Rheumatic mitral stenosis (RMS) increases the risk of both atrial fibrillation (AF) and thromboembolism. 

Methods: Patients with mitral stenosis and normal sinus rhythm were enrolled in the study prospectively.The present study was designed to study whether echocardiographic evaluation in patients with mitral stenosis and normal sinus rhythm could predict the occurrence of symptomatic AF . 

Results: Sixty-two patients (51 females) with mitral stenosis and normal sinus rhythm were included in the study. Seven patients (11.2%) developed symptomatic AF and the remaining 55 were free of AF during a followed-up of 22±5 months. The following echocardiographic parameters were significantly increased and predicted the development of AF: left atrial(LA) mediolateral diameter (5.5 ± 0.5 cm vs 4.7 ± 0.7 cm), right atrial mediolateral diameter (4,7 ± 1.0 cm vs 3.6 ± 1.3 cm), LA area in the apical two chamber view ( 31 ± 3.2 cm2 vs 25 ± 5.8 cm2), right atrial volume (52 ± 22 cm3 vs 34 ± 19 cm3), and interatrial conduction time (IACT) (132 ± 22 msec vs 115 ± 16 msec). 

Conclusions: This study revealed that echocardiography can be used to predict symptomatic AF in patients with RMS and sinus rhythm.