We did not observe any effect of elevated MV gradients on freedom from atrial fibrillation. On the contrary, elevated postrepair MV gradient was identified as a risk factor for late atrial fibrillation occurrence in recent studies by Kawamoto et al. [19] as well as Ma et al. [20]. We included only patients in sinus rhythm who did not undergo any ablation procedures, a characteristic that could provide an explanation for the differences observed between our results and those of Kawamoto et al. [19]. More importantly, we differentiated between atrial fibrillation and other types of atrial tachycardias as the mechanisms associated with the development of different atrial tachycardias after MV operations are known to fundamentally differ [7]. To adjust for potential unadjusted bias, future studies should include information on the type of incision made to expose the MV when exploring the effect of other factors on early and late atrial tachycardias. Previous studies also demonstrated that an elevated postrepair MV gradient impairs left atrial reverse remodelling [21]. Nevertheless, atrial fibrillation is most likely related to left atrial fibrosis that develops because of long-standing volume overload prior to the operation and is present even in patients in preoperative sinus rhythm [22]. More studies, with longer follow-up, are also needed to explore whether left atrial reverse remodelling in the presence of elevated postrepair gradient is impaired or only delayed. The results of our study do, however, suggest that the clinical burden of elevated postrepair gradient might be lower than previously suggested.