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What is the Difference Between Valvular and Non-valvular AF

The key difference between valvular and non-valvular AF is that valvular AF is a type of atrial fibrillation caused due to a problem with a heart valve, while non-valvular AF is a type of atrial fibrillation that is not caused due to a problem with a heart valve.

Atrial fibrillation (AF) is a state of irregular and very rapid heart rhythm. This can lead to blood clots in the heart. Ultimately, it increases the risk of stroke, heart failure, and other heart-related complications. Therefore, valvular and non-valvular atrial fibrillations are two types of atrial fibrillation.

CONTENTS

1. Overview and Key Difference
2. What is Valvular AF
3. What is Non-valvular AF
4. Similarities – Valvular and Non-valvular AF
5. Valvular vs Non-valvular AF in Tabular Form
6. Summary – Valvular vs Non-valvular AF

What is Valvular AF?

Valvular AF is a type of atrial fibrillation that is caused due to a problem with a heart valve. It is considered to be valvular when it’s observed in people who have a heart valve disorder or a prosthetic heart valve. Around 3 to 30% of people with atrial fibrillation are thought to have valvular atrial fibrillation. It is possible for a person with valvular AF to experience no symptoms. That person can have this condition for years and not realize it until he/she undergoes a physical examination and an electrocardiogram (EKG). However, if a person does experience valvular atrial fibrillation, the symptoms may include chest pain, dizziness, confusion, fatigue, heart palpitations (flip-flop heart), lightheadedness and shortness of breath, and unexplained weakness. One cause of valvular AF is mitral stenosis. This means the mitral valve is narrower in size than the normal size. Another cause of valvular AF is having an artificial heart valve.

Figure 01: Valvular AF

In addition to EKG tests, this condition can be diagnosed through echocardiogram, stress echocardiography, chest X-ray, and blood tests. Furthermore, doctors may use several treatments to prevent blood clots and control the heart rate and rhythm of the patient. Anticoagulation medications help to reduce the likelihood of blood clots. The most common is vitamin K antagonists (warfarin). The newer anticoagulation medications include non-vitamin K oral anticoagulants such as rivaroxaban, dabigatran, apixaban, and edoxaban. Cardioversion may be used to reset the heart’s rhythm by giving an electric shock. Other than that, certain medications can also help maintain the heart’s rhythm; these include miodarone, dofetillide, propafenone, and sotalol.

What is Non-valvular AF?

Non-valvular AF is a type of atrial fibrillation caused due to a problem like high blood pressure or an overactive thyroid gland. People are more likely to get non-valvular atrial fibrillation if they are older, experience high blood pressure for years, have heart disease, drink a large amount of alcohol, have a family member with atrial fibrillation, and have sleep apnea.

Figure 02: Non-valvular AF

The symptoms of non-valvular atrial fibrillation include chest discomfort, a fluttering in the chest, heart palpitations, lightheadedness or a feeling of fainting, shortness of breath, and unexplained fatigue. This medical condition can be diagnosed through physical examination, checking medical history, electrocardiogram, echocardiogram, stress test, chest X-ray, and blood tests. Furthermore, treatments for non-valvular AF include lifestyle changes (cutting back salt to reduce high blood pressure, having a healthy diet, reducing stress, avoiding alcohol, treating sleep apnea), medications such as anticoagulants to prevent blood clots (vitamin K antagonists (warfarin), non-vitamin K oral anticoagulants (dabigatran, rivaroxaban, apixaban), medications for heart rate control (beta-blockers or calcium channel blockers), medications to keep heart rhythm (ofetilide, amiodarone, sotalol) and other procedures (cardioversion, ablation, maze procedure, pacemaker with atrioventricular nodal ablation).

What are the Similarities Between Valvular and Non-valvular AF?

What is the Difference Between Valvular and Non-valvular AF?

Valvular AF is a type of atrial fibrillation caused due to a problem with a heart valve, while non-valvular AF is a type of atrial fibrillation that is not caused due to a problem with a heart valve. Thus, this is the key difference between valvular and non-valvular AF. Furthermore, valvular AF is mainly caused due to mitral stenosis and an artificial heart valve. On the other hand, non-valvular AF is mainly caused due to high blood pressure and an overactive thyroid gland.

The below infographic presents the differences between valvular and non-valvular AF in tabular form for side by side comparison.

Summary – Valvular vs Non-valvular AF

Valvular and non-valvular atrial fibrillations are two types of atrial fibrillation. Both types can cause blood clots in the heart, which increase the risk of stroke, heart failure, and other heart-related complications. Valvular AF is caused due to a problem with a heart valve. Non-valvular AF is a type of atrial fibrillation that is not caused due to a problem with a heart valve. So, this is the key difference between valvular and non-valvular AF.

Reference:

1. “Types of Atrial Fibrillation: Persistent, Paroxysmal & Permanent Afib.” WebMD.
2. Nall, Rachel. “What Is Nonvalvular Atrial Fibrillation?” Healthline, Healthline Media.

Image Courtesy:

1. “Phonocardiograms from normal and abnormal heart sounds” By Madhero88 – Own work Referencenetter image (CC BY-SA 3.0) via Commons Wikimedia
2. “RapidAFib150” By James Heilman, MD – Own work (CC BY-SA 3.0) via Commons Wikimedia