Atrial Fibrillation

My mother has an artificial St. Jude's aortic valve.  It was discovered this morning that she is atrial fibrillation.  Could valve failure be a cause of the atrial fibrillation?  Could there be any causative relationship between the two in any way?

[va_tony]

I'm not a doctor but here is my opinion.

Atrial fibrillation is often a result of valve problems, usually mitral valve regurgitation causing the left atrium to expand. There is a strong relationship between atrial size and your chances of getting afib. The aortic valve is on the same side of the heart as the mitral valve and regurgitation there will cause the left side of the heart to enlarge, including the left atrium (and so also leading to afib).

This doesn't imply that the replacement valve is causing the afib.  It's more likely that the heart enlargement occurred over time prior to surgery.  Also old age is also an afib risk factor. Many elderly have afib. So, your mother was a good candidate to develop afib eventually.  The fact that she is experiencing afib now is thus not surprising and may or may not be linked to the operation of the replacement valve.

How long ago did she have the valve replacement?

Best wishes

Tony

[PikaPika88]

In the other way, could A-Fib casue the valve regurgitation?

[va_tony]

Hi Pika

Left untreated, a high heart rate caused by afib will over time damage the heart (cause cardiomyopathy).

However, if the afib is rate controlled any damage is minimized.

The subject of rate-controlled afib induced damage is still controversial.  Some doctors claim it will still cause some enlargement and thickening of the ventricles. I talked to my EP and he felt, that with proper rate control (heart rate about 75) that there would be no damage to the ventricles. On the other hand, there is a chance of enlargement of the atrium.  It seems to me that if the atria becomes too enlarged it may pull the mitral valve out of shape and cause damage to. But I couldn't find anything on the internet discussing this. In fact, the large AFFIRM trial published 6 or 7 years ago seemed to conclude that those on rate-controlled afib lived as long (actually slightly longer) and were as healthy as those taking meds for ryhthm control (and in NSR).

Best wishes

Tony

[PikaPika88]

Hi Tony,

Thanks for that.  One echo said I got enlarged ventricle and one echo said I got enlarged atrium.  The chest X-ray said I got enlarge heart.  Seem the valves regurgitation (triscupid=moderate ; mitral=mild) happened in last 2 years.  Probably is due to my age=old.  A-Fib is also due to my age=old.  That's what the doctor said.  Doctor can treat A-Fib and valves but they can't treat "old".  Very said!

[va_tony]

Pika

You are not old!!  Nowadays, old is over 80. You're a youngster.  Don't you still have children going to school?

[PikaPika88]

Tony, I don't want to be old that quick.  But my cardio said my heart is getting old!  Isn't it meant no cure?  

My 2 daughters are in the uni.  

Sorry about the typo "Very said".  It should "Very sad".