Atrial fibrillation is commonly associated with organic metral valve disease including rheumatic valvular heart diasease or mitral valve prolapse and so forth. Although spontaneous sinus reversion may occur in some patients after mitral valve
operation,
recurrence of atrial fibrillation is the rule in most of these patients. We have tried to maintain sinus rhythm after mital valve operation with oral quinidine therapy, and we will show the efficacy of this therapy in this report. From January
1986
to
August 1992, 60 patients of mitral valvular heart disease. who had atrial fibrillation preoperatively and gained sinus rhythm postoperatively, were selected for this study. These patients were divided into 2 groups: Control group(n=30) and
Quinidine
trial group(n=30). The age, sex, duration of symptoms, left atria size and other risk factors of the reversion to atrial fibrilation were adjusted to be similar between the two groups. The maintenance rate of sinus rhythm was calculated by
Kaplan-Meier
method, and the rate was significantly higher in quinidine trial group than in control group(p=0.001). Univariate analysis was performed on the risk factors of reversion to atrial fibrillation, and the difference of maintenance rate between the
groups
were corrected with this result: the difference was still statistically significant(p=0.0205). The quinidine levels were measured in postoperative days, and there was no difference of serum quinidine level between the quinidine success group and
quinidine failure group. In conslusion. oral quinidine therapy was effective for the maintenance of sinus rhythm after mitra valve operation and there was no correlation between the serum quinidine level and clinical efficacy of quinidine therpy.
(Korean J Thoracic Cardiovas Surg 1994; 27:249-254)
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