Diltiazem is excellent for controlling your heart rate in atrial fibrillation, but it does not directly treat your valve conditions. For long-term management, your cardiologist will likely evaluate if you need a blood thinner (anticoagulant) to protect against stroke, which is crucial with atrial fibrillation. Depending on your heart's pumping function, other medications like beta-blockers might also be discussed. Essential precautions include having regular echocardiograms to monitor your valve regurgitation and pulmonary pressure, avoiding sudden medication changes, and immediately reporting symptoms like worsening shortness of breath, chest pain, or ankle swelling to your doctor.