Abstract:Objective To investigate the clinical effect of mechanical mitral valve replacement with concurrent radiofrequency ablation (RFA) in patients with rheumatic heart disease (RHD)complicated with atrial fibrillation(AF).? Methods A total of 96 RHD patients complicated with AF treated in Tongji Hospital from January 2013 to December 2015 were selected and divided into combined group(n=50)in which mitral valve replacement surgery with concurrent RFA and control group(n=46) in which drug treatment alone was given after mitral valve replacement surgery. The cardiopulmonary bypass (CPB) time, aortic occlusion time, postoperative drainage volume, levels of blood lactate and white blood cell, heart function and maintenance rate of sinus rhythm before and after operation were compared between two groups.? Results CPB time［(128.6±33.1)min vs (92.0±28.4)min], aortic clamping time [(91.6±16.8) min vs (79.2±14.3) min], postoperative drainage ［(936.2±110.8)ml vs (722. 9±144. 0)ml] in combined group were significantly higher than those in control group (all P<0.01). The maintenance rate of sinus rhythm in combined group was significantly higher than that in control group respectively at discharge, 3 months, 6 months and 1 year after discharge (P<0.05, P<0.01) ; the levels of lactic acid and white blood cell in combined group were significantly higher than those in control group at 2 h, 6 h, 1 d, 2 d and 3 d after operation(all P<0.05), the left atrial diameter in combined group was smaller than that in control group respectively at 3 months, 6 months and 1 year after operation (all P<0.05).? Conclusion The mechanical mitral valve replacement with concurrent RFA can increase operation difficulty and trauma degree in RHD patients complicated with AF, however, it has advantages in higher rate of postoperative sinus rhythm cardioversion and better recovery of left atrial diameter.