- Heart condition (atrial fibrillation)
- Consequences of injury (secondary condition)
The issue under appeal was whether the worker had entitlement for atrial fibrillation as a secondary condition to his compensable cardiac condition.
The appeal was allowed.The worker's treating physicians, including specialists in cardiology, were aware of the worker's non-compensable risk factors; however, expressly opined that the worker's atrial fibrillation was causally related to his mitral valve replacement surgery. This opinion was consistent with an article provided by the Tribunal's Medical Liaison Office (MLO) entitled, "Epidemiology of and risk factors for atrial fibrillation." The article indicates that cardiac surgery, including "valve surgery", increases the risk of atrial fibrillation by as much as "37 to 50 percent." Cigarette smoking is not identified as a risk factor for atrial fibrillation.The Panel found that the worker's stroke in 1996 and smoking history were not significant contributing factors to the development of his atrial fibrillation, but the worker's compensable cardiac condition was at least a significant contributing factor. The worker's accident had resulted in a number of secondary conditions requiring treatment and surgery, including mitral valve repair. The mitral valve repair surgery significantly contributed to the worker's subsequent atrial fibrillation. Accordingly, the worker had entitlement for the atrial fibrillation as a secondary condition resulting from the compensable accident.