Mechanistic insights into mitral regurgitation due to atrial fibrillation: “Atrial functional mitral regurgitation”

Mitral regurgitation (MR) is common, and definitive management of significant MR often requires percutaneous or surgical correction. Lone atrial fibrillation has been proposed to result in “atrial functional mitral regurgitation (AFMR)” via left atrial enlargement and mitral annular dilation. Patients with AFMR may represent a subgroup in which a rhythm control strategy may be preferred and catheter ablation is a promising nonsurgical therapy. This review discusses the anatomy of the mitral valve apparatus and MR classification schemes. Potential mechanisms in the pathogenesis of AFMR the implications for treatment will be discussed in detail.