Cardioversion following open-heart valvular surgery.

Abstract

Twenty-six patients underwent cardioversion for atrial fibrillation and flutter following open-heart valvular surgery. In 11 of these, a Starr-Edwards valve prosthesis was inserted. The procedure was successful in 23 (88%) and unsuccessful in 3 (12%). There were 8 recurrences over a period of 10 mo. Three failures and 3 recurrences occurred in those who had a prosthetic valve. In this series, prosthetic valves were employed in patients with mitral regurgitation (4), aortic regurgitation (1), and mitral stenosis with heavily calcified mitral valve (6). Factors associated with the underlying lesion rather than with the valve itself were responsible for these results. Proper selection of cases will increase the rate of successful cardioversion. Relative frequency of systemic embolism following the insertion of the prosthetic valves, especially in cases with a history of previous embolization, strongly justifies the attempt at cardioversion for atrial fibrillation and flutter.