Implanted Devices and Atrial Fibrillation

Atrial fibrillation (AF) is a supraventricular tachyarrhythmia characterized by uncoordinated atrial activation with consequent deterioration of atrial mechanical function. On the electrocardiogram (ECG), AF is characterized by the replacement of consistent P waves with rapid oscillations or fibrillatory waves associated with an irregular ventricular response. AF is the most common arrhythmia in clinical practice: its prevalence varies from 0.4% to 1% in the general population and increases with age, reaching 8% in patients older than 80 years [1]. AF may occur in a temporary causing condition setting, such as acute myocardial infarction, cardiac surgery, pericarditis, myocarditis, hyperthyroidism and pulmonary embolism, or in association with underlying cardiac disease such as valvular disease, coronary artery disease, hypertensive cardiomyopathy and others cardiomyopathies, especially those associated with left ventricular dysfunction and heart failure (HF). AF may also occur in younger patients without underlying cardiovascular disease and it is often referred to as “lone AF”. AF may develop in isolation or in association with other tachyarrhythmias, most commonly atrial flutter or atrial tachycardia, or bradyarrhtythmias especially due to sinus node dysfunction [1].