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Does atrial fibrillation lead to heart failure?

Q: My brother had udergone a replacement of a mitral valve (mechanical), 17 years back and he is 34 years old now. As per the doctor his heart is so enlarged that it cannot return to normal shape and he has chronic AF. Right now he is taking Dilgaurd XL180 OD, Lanoxin-OD, Acitrom-4mg, Aten 50mg twice a day. What's the life of a mechanical valve? Is there any permanent solution available for AF control and can it lead to heart failure?

A:The following are the answers to your queries: 1. Life of a mechanical valve is in-definitive and it usually last the life time of individual. However, it is prone to certain complications in form of blood clots forming on the valve and for which regular anticoagulation in form of Acitrom has to be taken life long. Infection can also form on the valve. Therefore whenever any dental procedure or urinary tract procedure has to be performed, prophylactic antibiotic cover should be provided. All this would be taken care of by your cardiologist. 2. There is no permanent solution available for atrial fibrillation control. Now days we are doing a operation called Maze operation and the same is being performed by cardiologist using percutaneous techniques but none of them is fool proof and is usually advised only if medical treatment of atrial fibrillation fails. In any case, this is again a very technical question and your treating cardiologist can only answer it for you or else you may contact us. 3. Yes, atrial fibrillation can create heart failure because in AF the upper chamber of the heart loose their capacity to effectively contract and therefore the contribution of the upper chambers of the heart to the out put of the blood from the heart is lost and the heart over a period of time can dilate or increase in size. Because his heart is significantly enlarged, therefore missing medication may create problem for him and one must make sure that medications are taken regularly and not missed.

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