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Mechanisms of atrial fibrillation
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Journal Article
Mechanisms of atrial fibrillation
2019
Overview
Atrial fibrillation (AF) is the most common sustained arrhythmia, currently affecting over 33 million individuals worldwide, and its prevalence is expected to more than double over the next 40 years. AF is associated with a twofold increase in premature mortality, and important major adverse cardiovascular events such as heart failure, severe stroke and myocardial infarction. Significant effort has been made over a number of years to define the underlying cellular, molecular and electrophysiological changes that predispose to the induction and maintenance of AF in patients. Progress has been limited by the realisation that AF is a complex arrhythmia that can be the end result of various different pathophysiological processes, with significant heterogeneity between individual patients (and between species). In this focused Review article, we aim to succinctly summarise for the non-specialist the current state of knowledge regarding the mechanisms of AF. We address all aspects of pathophysiology, including the basic electrophysiological and structural changes within the left atrium, the genetics of AF and the links to comorbidities and wider systemic and metabolic perturbations that may be upstream contributors to development of AF. Finally, we outline the translational implications for current and future rhythm control strategies in patients with AF.
Publisher
BMJ Publishing Group Ltd and British Cardiovascular Society,BMJ Publishing Group LTD
Subject
/ Atrial Fibrillation - diagnostic imaging
/ Atrial Fibrillation - etiology
/ Atrial Fibrillation - genetics
/ Atrial Fibrillation - physiopathology
/ Atrial Remodeling - physiology
/ Circuits
/ Electrophysiological Phenomena - physiology
/ Genetic Predisposition to Disease
/ Heart Atria - diagnostic imaging
/ Heart Atria - physiopathology
/ Humans
/ Magnetic Resonance Imaging - methods
/ Review
