Which statement is true about atrial fibrillation and left atrial flow in stenosis?

Which statement is true about atrial fibrillation and left atrial flow in stenosis?

• A. A-fib with continued LA flow is common with stenosis.
• B. A-fib with LA flow is never seen with stenosis.
• C. LA flow is unaffected by stenosis.
• D. A-fib eliminates LA flow in stenosis.

Answer: (A)

In stenosis, forward flow from the left atrium into the ventricle relies on the pressure gradient during diastole and the overall driving force, not solely on atrial contraction. When atrial fibrillation occurs, the organized atrial kick is lost, reducing but not abolishing this flow. The remaining diastolic gradient still pushes blood across the narrowed valve, so left atrial flow can continue, making atrial fibrillation with ongoing LA flow a common scenario in stenosis. The other statements imply no flow, unchanged flow, or complete elimination of flow, which aren’t accurate given the hemodynamics of a stenotic valve.

In stenosis, forward flow from the left atrium into the ventricle relies on the pressure gradient during diastole and the overall driving force, not solely on atrial contraction. When atrial fibrillation occurs, the organized atrial kick is lost, reducing but not abolishing this flow. The remaining diastolic gradient still pushes blood across the narrowed valve, so left atrial flow can continue, making atrial fibrillation with ongoing LA flow a common scenario in stenosis. The other statements imply no flow, unchanged flow, or complete elimination of flow, which aren’t accurate given the hemodynamics of a stenotic valve.