When the NOACs were first introduced
atrial fibrillation associated with any hemodynamically significant
valvular disease was considered valvular AF, excluding patients for
treatment with a NOAC. Subsequently NOAC indications with respect to
type of valve have been liberalized somewhat. The present consensus
seems to be that patients considered to have valvular AF are those
with rheumatic mitral disease, a valvular prosthesis (either tissue
or mechanical) and possibly those with MV repair. Here is a recent review.
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