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1.1 Epidemiology of atrial fibrillation Atrial fibrillation (AF) is the commonest sustained cardiac arrhythmia which affects 1 to 2 % of the entire adult population [1]. Current studies indicate that the prevalence of AF will be doubled in a few decades [2]. As a major source of public health problem, atrial fibrillation increases the risk of stroke (up to 18 fold especially in patients with valvular AF), long term disability, hospitalizations, cardiovascular mortality and healthcare costs [3-4]. The prevalence of atrial fibrillation and its complications are more common among patients with rheumatic heart disease especially in patients with mitral stenosis and regurgitation. Stroke is one of the most common and disabling complication of atrial fibrillation. Recent studies indicated that age, presence of hypertension, diabetes, heart failure and/or previous stroke or transient ischemic attack (TIA) as pivotal contributor risk factors to generation of stroke in AF patients [5-8]. Although the presence of these factors increases the risk of stroke in non-valvular AF patients, the absolute risk of stroke is much higher in patients with valvular AF [9].

Mitral Regurgitation and Atrial Fibrillation: The Contribution of Impaired Left Atrial Appendage Function to Atrial Thrombogenesis