1. Mitral Regurgitation in presence of AF 2. Echo(TTE), consider TEE if TTE inconclusive, for better resolution, planning surgery 3. Mgt-depends on MR & severity/symptoms/type(primary vs secondary MR), Meds: for AF- rate/rhythm control (B blocker), anticoagulate longterm DOAC- can be used if Mitraclip. Afterload reduction-can consider ACE-inhibitor, and also diuretic-if pulmonary congestion. Definitive Mgt-Normally Surgery-mitral valve repair/replacement-But given age consider transcatheter option-> Mitraclip.