Atrial Fibrillation Atrial Fibrillation Pathophysiology Implications for Management
نویسنده
چکیده
Atrial fibrillation (AF), the most common sustained cardiac arrhythmia, is an important contributor to population morbidity and mortality. An arrhythmia that is particularly common in the elderly, AF is growing in prevalence with the aging of the population. Our understanding of the basic mechanisms that govern AF occurrence and persistence has been increasing rapidly. This article reviews the basic pathophysiology of AF over a broad range of levels, touching on the tissue mechanisms that maintain the arrhythmia, the relationship between clinical presentation and basic mechanisms, ion channel and transporter abnormalities that lead to ectopic impulse formation, basic models and tissue determinants of reentry, ion channel determinants of reentry, the nature and roles of electric and structural remodeling, autonomic neural components, anatomic factors, interactions between atrial and ventricular functional consequences of AF, and the basic determinants of atrial thromboembolism. We then review the potential implications of the basic pathophysiology of the arrhythmia for its management. We first discuss consequences for improved rhythm control pharmacotherapy: targeting underlying conditions, new atrium-selective drug targets, new targets for focal ectopic source suppression, and upstream therapy aiming to prevent remodeling. We then review the implications of basic mechanistic considerations for rate control therapy, AF ablation, and the prevention of thromboembolic events. We conclude with some thoughts about the future of translational research related to AF mechanisms. (Circulation. 2011; 124:2264-2274.)
منابع مشابه
نقش عوامل خطر روانشناختی، سن و جنسیت در بروز فیبریلاسیون دهلیزی پس از جراحی بای پس عروق کرونر
Background and Objective: Atrial fibrillation is the most prevalent arrhythmia, accompanied with some adverse complications, after coronary artery bypass graft surgery. The purpose of this study was to investigate the role of psychological risk factors, as well as age and gender for the incidence of atrial fibrillation after coronary artery bypass graft surgery. Materials and Methods: In this r...
متن کاملIncidence of Atrial Fibrillation after Coronary Artery Bypass Graft Surgery and Its Risk Factors in Shiraz, Iran during 2017-18
Background and Objectives: Atrial fibrillation is one of the most common disorientations after coronary artery bypass graft surgery and can affect the chance of survival in the first year after surgery. The present study aimed to determine the incidence of atrial fibrillation after coronary artery bypass graft surgery and its risk factors. Methods: This cross-sectional study was performed on...
متن کاملAssessment of P-wave indices as atrial fibrillation predictors in psoriasis patients
Background: Psoriasis is a prevalent chronic T cell mediated inflammatory skin disorder. Recent studies have reported an increase in the incidence of arrhythmia in psoriasis patients who run an excessive risk of metabolic syndrome and cardiovascular diseases. P-wave dispersion (PWD) and duration are important electrocardiographic (ECG) markers employed to anticipate the risk of atrial arrhythmi...
متن کاملEffect of High Intensity Interval Training on the Level of Atrial Fibrillation, Fibroblast Growth Factor 23 and Klotho Protein in Male Rats with Renal Failure
Introduction: Cardiovascular problems and atrial fibrillation is one of the most prevalent secondary consequences in hemodialysis patients. This study aimed to examine the effect of high intensity interval training on the level of atrial fibrillation, fibroblast growth factor 23 and Klotho in male rats with chronic kidney disease. Methods: In this study, 30 male rats Wistar (7-8 weeks) were ra...
متن کاملModulation of extracellular atrioventricular node field potential pattern and ventricular rhythm by morphine in experimental atrial fibrillation in isolated rabbit heart
Introduction: Endorphins are produced by cardiomyocytes, and exert different effects on the heart. The aim of the present study is to assess morphine effects on extracellular atrioventricular (AV) node field potential pattern and ventricular rhythm of isolated rabbit heart during experimental atrial fibrillation (AF). Methods: Effects of different concentrations of morphine (10, 20, 50 and 1...
متن کاملتاثیر مکمل یاری ویتامین C در پیشگیری از فیبریلاسیون دهلیزی در بیماران تحت جراحی عروق کرونری
Background: Recently, the role of inflammation and oxidative stress in the pathophysiology of atrial fibrillation (AF) after cardiac surgery has been emphasized. Vitamin C as an antioxidant important role in reducing the incidence of postoperative atrial fibrillation. This study aimed to investigate, administration of vitamin C, as a way to reduce the incidence of atrial fibrillation after coro...
متن کامل