The role of corticosteroid therapy following surgery for atrial fibrillation.

Background: The objective of our study was to evaluate the usefulness of steroids therapy for patients who underwent surgery for chronic atrial fibrillation, with histologic findings of myocarditis.

Methods: Between April 1991 and July 2002, 144 patients underwent surgery for chronic atrial fibrillation at the time of other cardiac operations, at the Department of Cardiovascular surgery of the University of Bologna. Fragments of left and right appendages were provided for each patient for histologic study: In three patients myocarditis was identified and they were treated with steroid therapy until the postoperative day 60. We report here the case of our first successfully treated patient with a longer follow-up time.

Results: The patient was discharged on postoperative day 30, in sinus rhythm. At follow-up, 9 months after surgery, she was doing well and working full time; the ECG showed sinus rhythm, and echocardiography demonstrated biatrial contraction.

Conclusions: According to our experience, the histologic diagnosis of myocarditis allowed us to modify the therapeutic approach in patients who underwent surgery for atrial fibrillation, in which the addition of steroids to antiarrhythmic therapy, in the early postoperative period, is able to induce the recovery of sinus rhythm.