Atrial Fibrillation: The Most Common Arrhythmia in Rheumatic Heart Valve Disease

Among patients suffering from rheumatic valve heart disease, atrial fibrillation (AFib) is the most frequently observed type of arrhythmia. When AFib coexists with rheumatic heart valve disease, the likelihood of thromboembolic events significantly increases. Due to irregular contractions of the atria, blood can pool and form clots, particularly in the left atrial appendage. If a clot dislodges, it can travel through the bloodstream and cause blockages in other parts of the body. The most common complication is cerebral embolism, where the clot obstructs blood flow in a brain artery.

Increased Risk of Stroke in Rheumatic Heart Disease Patients with AFib

Patients with rheumatic heart disease who develop atrial fibrillation face a dramatically elevated risk of embolism compared to those without AFib. Studies show that the risk of embolic events can be up to 17 times higher in these patients. Moreover, individuals with both rheumatic valve disease and AFib experience a greater risk than those who have AFib without underlying valve issues. This heightened vulnerability underscores the importance of effective anticoagulation therapy.

Importance of Anticoagulation Therapy

To mitigate the risk of thromboembolism, medical guidelines strongly recommend the initiation of oral anticoagulation therapy with warfarin for patients with rheumatic valve disease and concomitant AFib. Unless contraindications exist, such as a high risk of bleeding or other medical limitations, anticoagulant treatment should be aggressively pursued. Regular monitoring of coagulation parameters, such as the INR (International Normalized Ratio), is essential to ensure therapeutic effectiveness while minimizing bleeding complications.

In summary, atrial fibrillation is not only the most common arrhythmia associated with rheumatic heart valve disease but also a critical factor that increases the risk of life-threatening embolic events. Timely and appropriate anticoagulation management is vital to reduce morbidity and improve patient outcomes.