Atrial fibrillation (AF) is independently associated with long-term excess mortality in patients with degenerative mitral regurgitation and should prompt consideration for surgery, researchers advise.

Guidelines for severe degenerative mitral regurgitation in the US and Europe classify AF as a class II indication, meaning it is not as strong an indicator for surgery as symptoms, LV EF<60% or end-systolic diameter of 40 mm or more, co-author Dr Maurice Enriquez-Sarano of Mayo Clinic in Rochester, Minnesota, USA said by email.