| Incidence of atrial fibriliation(AF) is 40～50% in rheumatic valvular heart disease, the incidence in mitral disease is higher than that in aortic disease. Incidence of atrial fibrillation(AF) in simple mitral stenosis is higher than that in simple mitral incompetence. The older of age, the lower of cardiac function and the larger of left atrial volume, the higher of the incidence of chronic AF. It has been shown that left auricle dilated and left atrial high pressure are the important factors which can contribute to AF in rheumatic heart disease(RHD). However, the electrocardiophysiological mechanism of AF is still unknown. Epicardial mapping of Harada, Sueda, Liii and Wang Zen Wei has showed that atrial flutter is more in left atrium(LA) than that in right atrium(RA) and atrial fibrillation is more in RA than in LA, so they deduce that AF is origin from left atrium(LA) and regular wave fronts reach along Bachman bunch, posterior part of LA and atrial septum, mutiple wave fronts interfere with each other and form complicated and compact fibrillation in RA. The pathological foundation of right atrial fibrillation in RHD is not clear. In AF patients with RHD, there are lots of clinic factors affecting myocardic pathology on right atrium: the damage of long-term rheumatic activity on right atrial structure, age, mitral regurgitation(MR) and tricuspid regurgitation(TR), cardiac status and the influence of pre-ioad and after-load in RA, etc. Therefore, the study on the RA pathological mechanism of right atrial fibrillation is based on other clinic factors affecting inyocardic pathology on right atrium similar. This study was taken as following. Step I . To limit factors which are concerned with right atrial fibrillation in RHD. Objective: To found comparable study of clinic factors in RI-ID patients between AF and sinus rhythm(SR).Methods: TWenty-nine patients with mitral valVe replacement of RHD were dividedinto AF grouPthel3) and SR grouP(n=l6) according to chronic AF or not. Then rejectivestandards were set and clinical factOrs were cootd statisticallyResults: There were no obvious statiStics diffierence between AF grouP and SRgrouP in age, RHD dUration(RHDd), FS, EF RA volurne(RAV), TR, MR, CVP,PAWP,MO and LAVConclusion: There was no obvious staistics diffierence betwen AF grouP and SRgrouP in clinical facors Which can contributn to AF AF grOuP was comParable with SRgrOuP. So thes StUdy can make a foUndation for the ther study of the relation betweenchronic AF and righ atrial pathological change in patients nd RHD.SteP II. To StUdy the connection betWen chronic AF and RA myocardialpathology in RHD patients.Objective: To study the RA myocardial pathological change in RHD patients withchronic AF or not and to investigate the pathOlogical basis ofrigh AF in RHD patiens.Methods: To make the qualitative and quantitaive StUdy wtth ligh microscopy andelectron microscopy on RA myocardium of AF grouP and SR pouP.ResultsStUdy ofligh microscoPy.The interstitial fibrosis, cellar hyPertrOPhy and the arrangemen of myocardiumconfused wee obviously seen in two grouPs, Aschoff bodies was not been found. NoStatstic difference was found in interstitial fibrosis and cellar hyPertrOPy degrCe betWentWo grouPs.StUdy of electron microscopy(l) Mitochondria: Crosta broken and dissolved cauld be foUnd obviously in AFgrouP. The mitochondrial volume in AF grOuP is smaller than that in SR grouP, andmitochondrial membrane was shrunken in AF grOuP. There was obvious relation betweenchronic AF and volume density specific sche, average area and average perimeter ofmitochondria.(2) Myoflbril: In two grouPs, following phenomenans cou...
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