Correlation of Left Atrial Size with Atrial Fibrillation in Patients of Mitral Stenosis Undergoing Percutaneous Transluminal Mitral Commissurotomy

Objective: To determine the frequency of atrial fibrillation in rheumatic mitral stenosis and to correlate it with left atrial size. Materials and methods: This Cross sectional study was conducted at the Department of Cardiology, Punjab Institute of Cardiology, from Jan 2007 to August 2007. One hundred consecutive patients with mitral stenosis undergoing Percutaneous Transluminal Mitral Commissurotomy (PTMC), more than 18 years of age, admitted in Cardiology ward were enrolled in this study. Patients with ischemic heart disease, thyrotoxicosis, hypertension, chest infections and prior cardiopulmonary surgery were excluded. All patients underwent thyroid function tests, cardiac enzymes and complete blood examination. Baseline electrocardiogram, chest x-ray and echocardiography were also carried out. Other variables studied were the symptomatology. Results: Out of one hundred patients, atrial fibrillation was noted in 35(35%) cases. The frequency of atrial fibrillation increased with age, being maximum (75%) after age 50 years. Similarly, there was a strong linear correlation between atrial fibrillation and left atrial size (r=0.0001). Dyspnoea was most common (78%) symptom, followed by palpitations (52%). Conclusion: Rheumatic mitral stenosis is one of the commonest cause of atrial fibrilllation and increased left atrial size is associated with increased frequency of atrial fibrillation in patients with mitral stenosis undergoing PTMC.