Atrial fibrillation is often described as either valvular AFib or nonvalvular AFib. AFib is considered valvular when seen in patients who have a heart valve disorder or a prosthetic heart valve in place. Nonvalvular AFib maybe caused by medical disorders such as high blood pressure, cardiomyopathy, or stress, to name a few.

With written permission from the patient, this video discusses the complex scenario of triple valve heart disease associated with atrial fibrillation, of more than two years duration. The patient underwent successful, aortic valve replacement, mitral valve repair, tricuspid valve repair, Cox-Maze IV AFib ablation, and closure of an atrial septal defect. The Cox-Maze IV procedure includes placing an AtriCure left atrial clip to occlude the left atrial appendage and prevent future embolic strokes.

The patient is being discharged at home in normal sinus rhythm. Although the patient is in normal sinus rhythm and has occlusion of the left atrial appendage, we will resume his Eliquis for 3-6 months until it is confirmed that he remains in normal sinus rhythm.

Arguably, thanks to the successful occlusion of the left atrial appendage, he may not need anticoagulant therapy going forward, even if he develops atrial fibrillation again in the future.