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Dokko et al. Vessel Plus 2022;6:37 Vessel Plus
DOI: 10.20517/2574-1209.2021.121

Review Open Access

Incidence, etiology, and outcomes of pre- and post-

operative atrial fibrillation in mitral valve
procedures: a review

1
2,#
1
1
Julia Dokko , Samantha Novotny , Lee Ann Santore , A. Laurie W. Shroyer , Thomas Bilfinger 2,#
1
Renaissance School of Medicine at Stony Brook University, Undergraduate Medical Education, Stony Brook, NY 11794-8434,
USA.
2
Department of Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY 11733-8191, USA.
#
Authors considered joint senior authors.
Correspondence to: Professor and Vice Chair for Research, A. Laurie W. Shroyer, Department of Surgery, Renaissance School of
Medicine at Stony Brook University, Health Science Center 19-080, 100 Nicolls Road, Stony Brook, NY 11733-8191, USA.
E-mail: AnnieLaurie.Shroyer@stonybrookmedicine.edu
How to cite this article: Dokko J, Novotny S, Santore LA, Shroyer ALW, Bilfinger T. Incidence, etiology, and outcomes of pre- and
post-operative atrial fibrillation in mitral valve procedures: a review. Vessel Plus 2022;6:37. https://dx.doi.org/10.20517/2574-
1209.2021.121

Received: 10 Sep 2021 First Decision: 12 Oct 2021 Revised: 2 Nov 2021 Accepted: 10 Feb 2022 Published: 9 Jun 2022

Academic Editors: Jun Feng And, Hossein Almassi Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Although pre-procedural and post-procedural atrial fibrillation occur commonly in mitral valve (MV) patients, the
impact on patient outcomes and resource utilization has not been well documented. A comprehensive PubMed
review was performed using a combination of MeSH terms related to atrial fibrillation, MV disease, MV and atrial
fibrillation procedures, and medical management. Additional publications were selected from the reference lists of
studies identified in the literature search. This review found that several studies conflict with the short-term
outcomes associated with pre- and post-operative atrial fibrillation in MV patients. In general, both pre- and post-
operative atrial fibrillation have clear negative long-term impacts on MV patients’ mortality and risk of stroke,
major bleeding and other thromboembolic events. Surgical ablation for pre-operative atrial fibrillation and
transcatheter ablation for medically resistant post-operative atrial fibrillation appears to be safe and effective
procedure; these percutaneous and surgical interventions have been documented to mitigate MV-related
thromboembolic risk. For MV patients, evidence suggests that the first step should be to optimize the current
medical therapy; for persistent symptoms not addressed medically, ablation procedures should be considered. To
optimize MV patients’ quality of care, however, additional research appears warranted to prevent long-term
adverse outcomes.

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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