Bi-atrial Versus Left Atrial Ablation for Patients With Rheumatic Mitral Valve Disease and Non-paroxysmal Atrial Fibrillation: a Multicenter, Prospective, Randomized Controlled Trial

What this Trial Is About

This research aims to compare the effectiveness of bi-atrial ablation versus left atrial ablation during mitral valve surgery in patients with rheumatic mitral valve disease who also have persistent atrial fibrillation. Atrial fibrillation is common in these patients and can increase the risk of death and stroke. The study explores whether targeting both atria provides benefits over treating only the left atrium, especially since right atrial involvement is common in this condition. Participants will undergo mitral valve surgery combined with either a bi-atrial ablation procedure, which treats both the left and right atria, or a left atrial ablation procedure alone. These procedures are performed during open heart surgery and aim to manage atrial fibrillation. The study is randomized and involves two groups receiving one of the two surgical ablation approaches. During the study, participants will be monitored for up to 12 months after surgery. Researchers will assess survival rates without atrial tachyarrhythmia recurrence, both with and without antiarrhythmic drugs, need for permanent pacemaker implantation, burden of atrial fibrillation, major adverse events, and heart function. These evaluations include medical history review, heart rhythm monitoring, and clinical assessments to understand the impact of each ablation method.

Bi-atrial Versus Left Atrial Ablation for Patients With Rheumatic Mitral Valve Disease and Non-paroxysmal Atrial Fibrillation