Mitral Academy - Atrial fibrillation

Atrial fibrillation

Palpitations are a relatively common symptom of both mitral regurgitation and mitral valve stenosis. In both regurgitation and stenosis, the increase in the intensity and frequency of the heart rate may originate from one of the most widespread arrhythmias in the world: atrial fibrillation.

What is atrial fibrillation?

This functional anomaly tends to occur often in the elderly and it originates from ectopic electrical pulses coming from the myocardial muscle cells located at the pulmonary vein-left atrial junction. An electrical disorder that has a negative effect on the left atrium, preventing it from working effectively: indeed, its “fragmentary” contraction is not valid from the haemodynamic perspective, i.e. on the aspect that directly concerns blood flow.

How many types of atrial fibrillation do we know about?

Arrhythmia can generally be defined as

paroxysmal: resolves spontaneously within a few days/hours and does not require drugs
persistent: when it requires external specialist intervention through targeted therapy
permanent

Why is it important to treat it?

Because it can give rise to blood clots (thromboses) which, once in circulation, risk reaching the brain and causing brain ischaemia or stroke. Furthermore, cardiovascular mortality is greater in those with atrial fibrillation compared to those who are healthy and because quality of life is very affected by it. Furthermore, persistent atrial fibrillation alters the geometry of the left atrium to the point that the arrhythmia tends not to disappear but to self-perpetuate.
Finally, recent studies have shown how atrial fibrillation increases the risk of heart failure by 500% and how arrhythmia affects - still in high percentage - other noncardiac pathologies, beginning from chronic kidney failure (+60%) and peripheral vasculopathy (+30%).