- Thank you for visiting this video
segment of Dr. Afib, I'm Dr. Morales.
February is heart month, so I wanted
to do some video features about how
atrial fibrillation affects your heart as a whole,
and not just talk only about atrial fibrillation.
So, in this video segment, we're gonna talk
about atrial fibrillation and valvular heart disease.
Now, in your body, in your heart,
you have four main heart valves.
Two on the right, two on the left.
The ones on the left more can affect
having atrial fibrillation.
First, I'll touch on aortic valve disease.
The aortic valve is the last valve in your heart,
as the blood is going out of your body,
out of your heart to the rest of your body,
and is more directly connected to the left ventricle.
People, when they have stenosis of the aortic valve,
which is fairly common, especially as people age,
or insufficiency, which is a leaky aortic valve,
more indirectly causes atrial defibrillation.
The way it works is that the aortic valve disease
first affects the left ventricle,
which is is the left, lower chamber of the heart,
then can affect the atrium, which is
the upper chambers of the heart.
So, there's a little more indirect effect
of how it can eventually cause atrial defibrillation.
However, what I mainly wanted to
focus on was the mitral valve.
The mitral valve is the one that is
directly connected to the left atrium,
and has a more direct effect in terms
of causing atrial defibrillation.
Now, many people have mild forms of mitral valve disease,
such as mild mitral valve insufficiency,
or mild mitral valve prolapse,
and those are very unlikely to cause
for atrial defibrillation.
However, as these valvular diseases get more moderate,
or even severe, what happens is that they put
a lot of direct pressure on the left atrium,
and the left atrium becomes more dilated and stretched,
develops more scar tissue, and that's what
eventually leads to atrial defibrillation.
So, of all your heart valves, it's the mitral valve
that has the more direct effect
in terms of causing atrial defibrillation.
However, once patients start developing
atrial defibrillation, and they have
fairly moderate, or severe, mitral valve disease,
what can you do about it?
What can you do about the atrial defibrillation itself?
I frequently tell patients that, if you have
severe valve disease in the mitral valve,
and you have atrial defibrillation,
yes, I can do an ablation on you,
but it's unlikely to be successful
because the root of the problem
is actually the mitral valve.
So, when the mitral valve becomes more severe,
in severity, whether it's stenosis, a stiff valve,
or regurgitation, a leaky valve,
frequently end up needing procedures,
whether that be surgery, or there is some
catheter-based procedures that can help with that as well.
I tell patients that in order to be able
to better control atrial defibrillation
you have to go to the root cause,
which is the mitral valve disease.
Fortunately, for patients whose valve got
so severe that they required actual surgery
in order to either repair or replace the mitral valve,
there are surgical ablations that can be done
that are also for the atrial defibrillation
at the same time of your heart surgery,
which can definitely help improve not only your
heart valve condition, but also your atrial defibrillation.
So, when people are undergoing mitral valve surgery
and they have a history of atrial defibrillations,
definitely recommended to do ablation for atrial
defibrillation at the same time, if possible.
When people are first diagnosed with atrial defibrillation,
one of the first tests to get done is an echocardiogram.
That's where we are looking for signs of
structural heart disease, which would include
valvular heart disease, because knowing
if you have a heart valve problem
certainly influences our ability and our
managing styles for treating your atrial defibrillation.
So, if you have atrial defibrillation,
please discuss with your doctor about
having an echocardiogram done to evaluate
for valvular heart disease.
Thank you for visiting this video segment of Dr. Afib.
I'll see you next time.