Atrial fibrillation surgery and mitral repair

Mitral disease is known to be associated to atrial fibrillation (AF) for decades. The most common association is with mitral stenosis, which produces an important dilatation and fibrosis of the left atrium due to volume overload. Interestingly, in young patients with mitral disease, sinus rhythm is maintained even with a very enlarged left atrium, but when AF starts, it is to stay in what is was called chronic AF and nowadays persistent and after one year, long-standing AF.