title: The definition of valvular and non-valvular atrial fibrillation: results of a physicians' survey.
abstract: OBJECTIVE
  To assess different aspects of the definition of valvular/non-valvular atrial fibrillation (AF) used in clinical practice by physicians who usually treat this condition.
  
  
  RESULTS
  We prospectively conducted a web-based survey including cardiologists and internists who attended continuing medical education courses on cardiovascular medicine. A questionnaire was drawn up, containing 17 questions clustered into five main topics: (A) known rheumatic aetiology; (B) site/type of valve involvement; (C) prosthetic heart valve; (D) haemodynamic relevance; (E) miscellaneous. The overall response rate was 22.4% (21.1% for cardiologists and 24% for internists). Coexistence of both medical history of rheumatic disease and clinical signs of valvular involvement were considered as essential prerequisites for the diagnosis of rheumatic AF by half of the respondents, and one-third assumed that lone aortic valve disease was sufficient for AF to be defined as valvular. A similar proportion of respondents considered that in the presence of mitral regurgitation, AF had to be defined as valvular. The majority of responding physicians considered the degree of valvular defect of lesser importance for the definition of valvular or non-valvular origin of AF.
  
  
  CONCLUSIONS
  We found important heterogeneity and uncertainties in the answers given by physicians who usually treat patients with AF, as evidence of the lack of precise and unique definitions of the origin of AF (valvular/non-valvular). It is urgent to issue clear widely accepted definitions of the origin of AF, which should improve clinical practice and research.
authors.affiliation: Internal Medicine Division, Medical Department, Vimercate Hospital, Via Santi Cosma e Damiano, 10, 20871 Vimercate, Italy mauro.molteni@aovimercate.org.
authors.forename: Mauro
authors.initials: M
authors.lastname: Molteni
authors.affiliation: Internal Medicine Division, Medical Department, Vimercate Hospital, Via Santi Cosma e Damiano, 10, 20871 Vimercate, Italy.
authors.forename: Hernan
authors.initials: H
authors.lastname: Polo Friz
authors.affiliation: Internal Medicine Division, Medical Department, Vimercate Hospital, Via Santi Cosma e Damiano, 10, 20871 Vimercate, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Primitz
authors.affiliation: Department of Clinical Science and Community Health, Units of Medical Statistics, University of Milan, Campus Cascina Rosa, Via Vanzetti 5, 20133 Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Marano
authors.affiliation: Department of Clinical Science and Community Health, Units of Medical Statistics, University of Milan, Campus Cascina Rosa, Via Vanzetti 5, 20133 Milan, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Boracchi
authors.affiliation: Internal Medicine Division, Medical Department, Vimercate Hospital, Via Santi Cosma e Damiano, 10, 20871 Vimercate, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Cimminiello
mesh_terms: D001281:Atrial Fibrillation / Q000145:classification* / Q000175:diagnosis* / Q000209:etiology; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006349:Heart Valve Diseases / Q000145:classification* / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D038622:Internationality; D010820:Physicians / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D009626:Terminology as Topic; D018875:Vocabulary, Controlled
keywords: Anti-thrombotic therapy; Atrial fibrillation; Non-valvular; Stroke; Survey; Valvular