Mitral stenosis and atrial fibrillation

Over the past decades, the incidence of mitral stenosis (MS) due to rheumatic fever has markedly decreased. Regardless, rheumatic fever remains associated with about 80% of all cases of MS, and so relatively the most relevant contributor to MS.1 Aside from rare causes such as congenital MS, MS due to myxoma or MS following infiltrating diseases, another important cause of MS is indeed severe calcification of the mitral annulus and its leaflets. While this may become more frequent in the ageing population, it only rarely causes severe MS.2 Due to the pathomechanism of MS, which includes left atrial enlargement due to constant pressure and volume overload, the prevalence of atrial fibrillation is high.1 Oral anticoagulation is recommended not only in patients with atrial fibrillation, but also in those with sinus rhythm and dense spontaneous echocardiographic contrast and/or large left atrium.3 Unfortunately, only few data are available on the complication rates of …