Atrial Fibrillation Awareness Month: 5 Facts Heart Valve Patients Should Know
If you didn’t know, September is National Atrial Fibrillation Awareness Month. As many patients in our community have heart valve disease and atrial fibrillation, here are 5 important facts about atrial fibrillation.
1. What is Atrial Fibrillation?
Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in clinical practice. Its incidence increases with age and the presence of structural heart disease – like valvular disorders including mitral regurgitation. Stroke and heart failure may result patients with atrial fibrillation.
To help you learn more about atrial fibrillation, I made this video with Dr. Vincent Gaudiani, a leading heart valve surgeon who has performed over 10,000 cardiac procedures in Northern California.
2. Is it common for patients with heart valve disease to have atrial fibrillation?
In an exchange with Dr. Patrick McCarthy, the Chief of Cardiac Surgery at Northwestern Medicine, I learned that about 30% his patients have a known pre-operative history of atrial fibrillation. Interestingly, some patients are asymptomatic and not aware they have atrial fibrillation. Atrial fibrillation is more common as you age. It usually starts out with episodes that come and go, so it can be difficult to document.
Dr. Patrick McCarthy
Over time, the Afib episodes become more frequent and may no longer convert to a normal rhythm on their own. Without treatment, Afib can become chronic. Having Afib increases the risk of stroke, so it is important to diagnose and treat it.
3. Does valve disease cause Afib? Or, does Afib cause valve disease? Or, can they both impact each other?
Thanks to Jane Kruse, the heart valve and atrial fibrillation clinic coordinator at Northwestern Medicine, I learned that AFib doesn’t typically cause valve disease, but there is a relationship between them. Most Afib originates in the left atrium. In patients with mitral valve regurgitation, the blood flows backwards into the left atrium and makes that heart chamber enlarge.
Mitral Regurgitation Diagram
Often, Afib will result from this. When this happens in asymptomatic patients severe mitral regurgitation, it is a sign that it is time for surgery to fix the valve. Occasionally, Afib can cause mitral annular dilatation and lead to secondary mitral and/or tricuspid valve regurgitation.
4. What percent of patients needing heart valve surgery require concomitant Afib treatment?
In discussing this question with Dr. McCarthy, I discovered that of all types of cardiac surgery patients presenting with a history of atrial fibrillation, Northwestern treats the atrial fibrillation in about 80% of the cases. It only adds a few minutes to the procedure and, in general, gives an 80% chance of eliminating the Afib.
5. Is there anything else that heart valve patients should know about Afib?
Dr. McCarthy and Jane informed me that Afib can happen after cardiac surgery in about 30-40% of patients who never had Afib prior to surgery. This type of Afib is usually short-lived and resolves within a few months after surgery. When patients have Afib after surgery, they are started on new medications — for a few months — to thin the blood and help control the heart rhythm until they go back to a normal heart rhythm.
I hope this helped you learn more about Afib. Thanks to Dr. Gaudiani, Dr. McCarthy and Jane Kruse for sharing their research and clinical experiences treating patients with Afib and heart valve disease.
Keep on tickin!
Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of HeartValveSurgery.com.