The infrequent association of bacterial endocarditis with auricular fibrillation and with severe mitral stenosis is noted. The relevant literature is reviewed. Eighty-two cases of bacterial endocarditis superimposed on rheumatic heart disease and 47 examples of bacterial endocarditis without underlying rheumatic valvulitis are studied. Auricular fibrillation and severe mitral stenosis occurred less frequently in these groups than in patients with rheumatic heart disease without bacterial endocarditis. Various theories to account for these observations are analyzed and an alternative explanation is offered.