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The study was done to define the incidence, determinants and prognostic implications of onset of atrial fibrillation (AF) during follow-up of mitral regurgitation (MR) initially in sinus rhythm.

The rates and clinical implications of AF in MR are undefined.

We analyzed the occurrence of AF under conservative management in two populations of patients with degenerative MR in sinus rhythm at diagnosis: 1) 360 patients (65 ± 13 years, 74% men) with MR due to flail leaflets; and 2) 89 residents of Olmsted County, Minnesota (67 ± 17 years, 56% men) with grade 3 or 4 MR due to simple mitral valve prolapse (MVP) diagnosed echocardiographically.

In patients with MR due to flail leaflets, AF rates at 5 and 10 years were 18 ± 3% and 48 ± 6%, respectively, and the linearized rate was 5.0 ± 0.7% per year. Development of AF during follow-up was independently associated with high risk of …